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

Mod Rheumatol. 2021 Sep;31(5):979-986. doi: 10.1080/14397595.2020.1838402. Epub 2020 Nov 2.

Abstract

Objectives: To investigate the clinical and psychosocial backgrounds of frailty in rheumatoid arthritis (RA) patients.

Methods: Patients with RA between 40 and 79 years of age who visited university hospitals in an urban area were recruited. Well-validated self-reported questionnaires were used to evaluate patient physical function (Health Assessment Questionnaire, HAQ), depressive symptoms (Beck Depression Inventory-II, BDI-II), and frailty (Kihon Checklist). A 28-point Disease Activity Score (DAS-28) was calculated to evaluate RA disease activity.

Results: A total of 375 RA patients, 323 of whom were women, were enrolled (average age: 65.2 ± 9.7 years; average disease duration: 16.6 ± 11.9 years). The prevalence rates of frailty, working-age (40-64 years), young-old (65-74 years), and old-old (≥75 years) patients were 18.5, 28.8, and 36.6%, respectively. Higher age and longer disease duration were associated with frailty. Multivariable logistic regression analysis revealed that HAQ, DAS-28, and BDI-II scores were independently associated with frailty in RA patients.

Conclusion: Frailty is common, even among working-age RA patients. Physical function, disease activity, and depressive symptoms were independently associated with frailty. A multidisciplinary intervention approach, along with adequate pharmacological therapy, may promote successful aging in patients with RA.

Keywords: Aged; depression; frailty; patients; rheumatoid arthritis.

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid* / complications
  • Arthritis, Rheumatoid* / diagnosis
  • Arthritis, Rheumatoid* / epidemiology
  • Depression / complications
  • Depression / diagnosis
  • Depression / epidemiology
  • Female
  • Frailty* / complications
  • Frailty* / diagnosis
  • Frailty* / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Severity of Illness Index
  • Surveys and Questionnaires