Purpose Frailty occurs prematurely in rheumatoid arthritis (RA) and is associated with poor health outcomes. We compared the performance of four frailty instruments, including a pragmatic alternative measure using chair sit‐to‐stand (STS), and evaluated their abilities to predict poor health outcomes. Methods Frailty was measured at baseline using four instruments: Fried Frailty Phenotype with STS (Fried‐STS), Fried Frailty Phenotype with hand grip strength (Fried‐HGS), VA‐Frailty Index (VA‐FI), and FRAIL Scale (FRAIL). Outcomes collected at 1‐year follow‐up included category of falls (none, 1, >1), category of days hospitalized (none, 1‐3, >3), and a composite outcome of fall, hospitalization or death. Ordinal logistic or logistic regression models, adjusted for age and sex, explored the association of frailty and each outcome. Results 143 participants were included, aged 64.5±11.7 years, 73% male, and 69% White. Categorization as frail differed by instrument: Fried‐STS (17%), Fried‐HGS (15%), VA‐FI (36%), and FRAIL (20%). There was poor agreement between frailty instruments (k=0.07‐0.31) except for Fried‐STS and Fried‐HGS (k=0.62). Frailty by Fried‐STS, Fried‐HGS, and FRAIL were associated with falls (aORs: 3.83‐9.54, p<0.05). Frailty by VA‐FI was associated with days hospitalized (aOR: 5.21, p=0.017). Frailty by Fried‐STS, VA‐FI, and FRAIL were all associated with higher odds of the composite measure of incident fall, hospitalization, or death (aORs: 2.93‐7.25, p<0.05). Conclusion Each frailty measure predicted adverse health outcomes, with phenotypic and patient‐reported measures predicting falls while the deficit accumulation model predicted hospitalization days. Being frail by Fried‐HGS did not predict poor outcomes as well as the other frailty instruments, including Fried‐STS.
Riggles et al. (Sun,) studied this question.