Depression, physical function, and disease activity associated with frailty in patients with rheumatoid arthritis

Kojima, Masayo; Kojima, Toshihisa; Waguri-Nagaya, Yuko; Takahashi, N.; Asai, Shuji; Sobue, Yasumori; Nishiume, Tsuyoshi; Suzuki, Mochihito; Mitsui, Hideaki; Kawaguchi, Yohei; Kuroyanagi, Gen; Yasuoka, Mikako; Watanabe, Miki; Suzuki, Sadao; Arai, Hidenori

doi:10.1080/14397595.2020.1838402

Cited by 26 publications

(54 citation statements)

References 42 publications

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“…One study, using CDAI, found that this relationship was no longer evident after adjusting for age 33 . In contrast, two other studies, showed that frailty remained associated with a higher baseline DAS-28 score after adjustment for age, sex, duration of rheumatoid arthritis and physical impairment (quantified using the Health Assessment Questionnaire -Disability Index (HAQ-DI)) 25,27 .…”

Section: Rheumatoid Arthritis Disease Activitymentioning

confidence: 86%

“…Findings were mixed, with three studies showing no association between frailty and disease duration 10,20,27 . By contrast, two studies showed that frailty was associated with greater duration of rheumatoid arthritis at the time of assessment 25,29 , however only one of these studies additionally adjusted for age in the analysis 25 .…”

Section: Duration Of Rheumatoid Arthritismentioning

confidence: 97%

“…Ten studies, using seven different frailty measures and four different markers of rheumatoid arthritis disease activity (four using Disease Activity Score in 28 joints, two using the Rheumatoid Arthritis Disease Activity Index, two using Simple Disease Activity Index and two using Clinical Disease Activity Index) all showed a significant cross-sectional association between frailty status and activity of rheumatoid arthritis before adjustment for additional factors 10,11,20,21,25,[27][28][29][30]33 . One study, using CDAI, found that this relationship was no longer evident after adjusting for age 33 .…”

Section: Rheumatoid Arthritis Disease Activitymentioning

confidence: 99%

“…Seven studies assessed the relationship between frailty and physical function using the HAQ-DI 11,12,21,22,25,27,28,30,33 . Each of these studies demonstrates an association between frailty and higher baseline HAQ scores (indicating a greater degree of physical impairment).…”

Section: Physical Functionmentioning

confidence: 99%

“…Five studies assessed the relationship between frailty and the duration of rheumatoid arthritis at baseline 10,20,25,27,29 . Findings were mixed, with three studies showing no association between frailty and disease duration 10,20,27 .…”

Section: Duration Of Rheumatoid Arthritismentioning

confidence: 99%

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Frailty in people with rheumatoid arthritis: a systematic review of observational studies

et al. 2021

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Background: Frailty, an age-related decline in physiological reserve, is an increasingly important concept in the management of chronic diseases. The implications of frailty in people with rheumatoid arthritis are not well understood. We undertook a systematic review to assess the prevalence of frailty in people with rheumatoid arthritis, and the relationship between frailty and clinical outcomes. Methods: We searched three electronic databases (January 2001 to April 2021) for observational studies assessing the prevalence of frailty in adults (≥18 years) with rheumatoid arthritis, or analysing the relationship between frailty and clinical outcomes in the context of rheumatoid arthritis. Titles, abstracts and full texts were assessed independently by two reviewers. Study quality was assessed using an adapted Newcastle-Ottawa Scale. Results: We identified 17 analyses, from 14 different sample populations. 15/17 were cross-sectional. These studies used 11 different measures of frailty. Frailty prevalence ranged from 10% (frailty phenotype) to 36% (comprehensive rheumatologic assessment of frailty) in general adult populations with rheumatoid arthritis. In younger populations (<60 or <65 years) prevalence ranged from 2.4% (frailty phenotype) to 19.9% (Kihon checklist) while in older populations (>60 or >65) prevalence ranged from 31.2% (Kihon checklist) to 55% (Geriatric 8 tool). Frailty was associated with higher disease activity (10/10 studies), lower physical function (7/7 studies), longer disease duration (2/5 studies), hospitalization (1/1 study) and osteoporotic fractures (1/1 study). Conclusion: Our review found that frailty is common in adults with rheumatoid arthritis, including those aged <65 years, and is associated with a range of adverse features. However, these is substantial heterogeneity in how frailty is measured in rheumatoid arthritis. We found a lack of longitudinal studies making the impact of frailty on clinical outcomes over time and the extent to which frailty is caused by rheumatoid arthritis unclear.

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Section: Rheumatoid Arthritis Disease Activitymentioning

confidence: 86%

Section: Duration Of Rheumatoid Arthritismentioning

confidence: 97%

Section: Rheumatoid Arthritis Disease Activitymentioning

confidence: 99%

Section: Physical Functionmentioning

confidence: 99%

Section: Duration Of Rheumatoid Arthritismentioning

confidence: 99%

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Frailty in people with rheumatoid arthritis: a systematic review of observational studies

et al. 2021

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Psychometric Properties of Frailty Instruments in Adults With Rheumatoid Arthritis: A Systematic Review

Loecker,

Schmaderer,

Wysham

et al. 2023

ACR Open Rheumatology

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ObjectiveExamine psychometric properties of frailty instruments used in adults with rheumatoid arthritis (RA) to inform selection of frailty instruments for clinical and research use.MethodsA systematic review was registered in PROSPERO. Studies measuring frailty in adults with RA published before May 25, 2022, were searched in six electronic databases. Level of evidence of psychometric properties were synthesized and graded for each frailty instrument using Consensus‐Based Standards for the Selection of Health Measurement Instruments methodology.ResultsThere were 22 articles included in the review, and psychometric properties of 16 frailty instruments were examined. RA cohorts were predominantly female with moderate RA disease activity, mean age was 60.1 years, and frailty prevalence ranged widely from 10% to 85%. Construct validity was the only psychometric property routinely examined for frailty instruments in RA, and nearly all (14/16) performed favorably in this domain. Frailty correlated most frequently with older age, higher RA disease activity, and worse physical function. Internal consistency, measurement error, and content validity were examined infrequently. Reliability and responsiveness data were not reported. Six frailty instruments were rated highest in adults with RA: three adaptations of Fried's Criteria, 32‐Item and 45‐Item Frailty Indexes, and the Comprehensive Rheumatologic Assessment of Frailty.ConclusionSix frailty instruments possessed the highest‐rated psychometric properties in RA. These instruments demonstrated construct validity of frailty with important outcomes in RA. Frailty assessment shows promise to inform risk stratification in RA, but studies are needed to evaluate reliability, responsiveness, and validity to support accuracy of frailty measurement in adults with RA who may have disease‐related features that differentially impact outcomes.

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Factors associated with frailty in Japanese patients with rheumatoid arthritis: results from the Institute of Rheumatology Rheumatoid Arthritis cohort study

Furuya

Ikari

et al. 2021

Clin Rheumatol

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Depression, physical function, and disease activity associated with frailty in patients with rheumatoid arthritis

Cited by 26 publications

References 42 publications

Frailty in people with rheumatoid arthritis: a systematic review of observational studies

Frailty in people with rheumatoid arthritis: a systematic review of observational studies

Psychometric Properties of Frailty Instruments in Adults With Rheumatoid Arthritis: A Systematic Review

Factors associated with frailty in Japanese patients with rheumatoid arthritis: results from the Institute of Rheumatology Rheumatoid Arthritis cohort study

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