Background/Purpose:  Fatigue is a frequently mentioned symptom by people living with rheumatoid arthritis (RA). However, little research has explored the associations between fatigue and other indicators of health and well-being in this population, such as cardiovascular disease (CVD) and quality of life. Therefore, the current study aimed to examine the relationships between fatigue and disease activity, CVD risk, as well as psychological well-being.

Methods:  98 RA patients (66 female, 54 (12) years) completed the Multidimensional Assessment of Fatigue Scale, as well as questionnaires measuring depression, anxiety, subjective vitality, quality of life, and functional ability. CVD risk was assessed with blood pressure, body mass index, cardiorespiratory fitness, as well as serological measures (e.g., lipids, insulin resistance) and Qrisk was used to measure global CVD risk. Disease activity was measured by DAS28 and inflammatory markers. Participants were divided into tertiles based on levels of low (mean [SD] fatigue = 15.5 [4.7]), moderate (mean [SD] fatigue = 27.8 [3.3]) and high (mean [SD] fatigue = 39.9 [4.2]) levels of fatigue. Group differences were analysed by one-way Analyses of Variance, corrections were made for multiple comparisons.

Results:  The fatigue groups did not differ with regards to age and sex. Clinical disease activity (p=.03), but not serological markers of inflammation, was different between the three fatigue groups. Those with greater levels of fatigue had lower functional ability, quality of life and subjective vitality, and higher anxiety and depression (p’s<.01). Measures of insulin resistance (p’s<.02), HDL cholesterol (=.03) and cardiorespiratory fitness (p=.03) were poorer in those with high fatigue (p’s<.02), but no other markers of CVD risk (e.g., BMI, lipids, blood pressure) differed between the groups.

Conclusion:  These results showed that RA patients with lower levels of fatigue also reported better psychological well-being, functional ability and DAS28 and some CVD risk indicators, but no differences were observed for levels of inflammation. These cross-sectional associations between fatigue and well-being suggest that improving psychological wellbeing, functional ability and cardiorespiratory fitness could also induce improvements in fatigue. However, this will need to be confirmed in longitudinal and intervention studies in which associations between improvements in psychological wellbeing and fatigue can be determined.

« Back to 2016 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/correlates-of-fatigue-in-people-living-with-rheumatoid-arthritis/