Session Information
Date: Sunday, October 21, 2018
Title: Rheumatoid Arthritis – Diagnosis, Manifestations, and Outcomes Poster I: Comorbidities
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Prevalence and relative factors for frailty in patients with RA from a prospective observational study
Background/Purpose: Frailty is defined as degradation of physical and cognition function in elderly adult. The characteristics of frailty include not only physical problems as co-morbidity and disability, but also mental and social problems. It is unclear of relationship between frailty and disease activity of patients with rheumatoid arthritis (RA). We investigated the relative factors about frailty in patients with RA from a prospective observational study.
Methods: 95 from 100 patients entered the CHIKARA study (Correlation researcH of sarcopenIa, sKeletal muscle and disease Activity in Rheumatoid Arthritis) were investigated by frailty check list (maximal score is 25). According to reported article, frailty was defined from 8 to 25 and pre-frailty was from 4 to 7, and normal was from 0 to 3. We investigated relationship of disease activity in frailty, pre-frailty and normal groups, and analyzed the relative factors for frailty.
Results: The prevalence of frailty, pre-frailty, and normal was 19%, 39% and 42%, respectively. The character of groups indicated at Table 1. Frailty group was the oldest of three groups. Disease activity sore 28 erythrocyte sedimentation rate (DAS28ESR) and matrix metalloproteinase 3 (MMP3) of frailty group was higher than those of pre-frailty and normal groups. Whereas, modified health assessment questionnaire (mHAQ) of frailty group was lower than those of pre-frailty and normal groups. Normal was 66.6% and frailty was 6.7% in remission patients. However, Normal was 13.3% and frailty was 46.7% in moderate and high disease activity patients. The prevalence of frailty was increased with disease activity. The relative factors for frailty in patients with RA indicated at Table 2. Age, locomotive syndrome, DAS28ESR, mHAQ, and Steinbroker class were related positively and leg muscle score and grip strength were related negatively by univariate analysis. Steinbroker class (odds ratio: 3.25 95%CI: 1.11-9.51, P=0.031) and mHAQ (odds ratio: 1.29, 95%CI: 1.13-1.46, P<0.001) were independent relative factors by multivariate analysis.
Conclusion: It was revealed that frailty involved disease activity and physical function in patients with RA. Control of disease activity is important to prevent not only disease progression, but also frailty.
Table 1. The character of frailty, pre-frailty, and normal in patients with RA
|
Frailty (19%) |
Pre-frailty (39%) |
Normal (42%) |
P value |
|
|
Age, years |
72.5 ± 10.3 |
68.6 ± 11.3 |
60.7 ± 16.4 |
0.01 |
|
Leg muscle score |
84.9 ± 5.9 |
86.2 ± 6.4 |
93.2 ± 9.7 |
<0.001 |
|
Grip, kg |
12.6 ± 6.9 |
17.7± 7.1 |
18.1± 6.2 |
0.013 |
|
Locomotive 5 score |
11.1 ± 5.8 |
6.4 ± 4.9 |
2.6 ± 4.0 |
<0.001 |
|
MMP3, ng/dl |
143.7 ± 122.0 |
95.9 ± 66.0 |
88.6 ± 52.0 |
0.033 |
|
DAS28ESR |
3.62 ± 0.97 |
3.27 ± 1.02 |
2.83 ± 0.96 |
0.015 |
|
mHAQ |
0.9 ± 0.7 |
0. 4 ± 0.2 |
0.1 ± 0.1 |
<0.001 |
|
Sarcopenia, % |
39 |
41 |
18 |
0.063 |
Table 2. Relative factors for frailty in patients with RA
|
Univariate |
Multivariate |
|||
|
R value |
P value |
Odds ratio |
95%CI |
|
|
Age, years |
0.203 |
0.048 |
||
|
Locomotive syndrome |
0.397 |
<0.001 |
||
|
Leg muscle score |
-0.222 |
0.031 |
||
|
Grip strength, kg |
-0.272 |
0.008 |
||
|
DAS28ESR |
0.228 |
0.026 |
||
|
mHAQ |
0.413 |
<0.001 |
1.29 |
1.13-1.46 |
|
Steinbrocker class |
0.331 |
0.001 |
3.25 |
1.11-9.51 |
To cite this abstract in AMA style:
Tada M, Yamada Y, Mandai K, Hidaka N. Prevalence and Relative Factors for Frailty in Patients with RA from a Prospective Observational Study [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/prevalence-and-relative-factors-for-frailty-in-patients-with-ra-from-a-prospective-observational-study/. Accessed .« Back to 2018 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/prevalence-and-relative-factors-for-frailty-in-patients-with-ra-from-a-prospective-observational-study/