Self-Reported Frailty Prevalent Among Patients With Rheumatic Musculoskeletal Diseases

Self-reported frailty is prevalent in one-third of patients with rheumatic musculoskeletal diseases (RMDs), with age, disease duration, pain, prior fractures, and weight associated with increased risk for frailty, according to study results presented at the American Society for Bone and Mineral Research (ASBMR) 2020 Annual Meeting, held virtually from September 11 to 15, 2020.

The objective of the study was to investigate the prevalence of self-reported frailty among patients with RMDs, and to identify risk factors for frailty in these patients. Using data from FORWARD, The National Databank for Rheumatic Diseases, the largest patient-reported RMD research databank in the United States, the researchers categorized patients with RMDs who met ≥3 of the 5 criteria as “frail.” The 5-item patient-reported frailty scale included questions about fatigue, ability to walk several blocks, climb 10 stairs, weight loss, and 11 comorbidities.

A total of 1422 responses (86.5% from women) were collected, and the most common RMDs were found to be rheumatoid arthritis (n=901; 63%) and osteoarthritis (OA; n=213; 15%). Of the entire cohort, 420 (30%) participants met the criteria for frailty. The top 3 factors contributing to frailty scores were inability to walk several blocks, inability to climb 10 stairs, and ≥5 of the 11 comorbidities.

Compared with patients who were not categorized as frail, those who were categorized as frail were older (64.5 vs 67.4 years, respectively; odds ratio [OR], 1.04), had longer disease duration (22.8 vs 25.9 years, respectively; OR, 1.01), and a higher pain scale (2.78 vs 4.42, respectively; OR, 1.23; all P <.05). Furthermore, obesity (56.2% vs 29.7%, respectively) and prior fracture (42.9% vs 24.6%, respectively; OR, 2.02; P <.05) were more common among participants who were frail compared with those who were not frail.

Despite being the youngest group (mean age, 61±12 years), patients with systemic lupus erythematosus (SLE) were observed to have the highest proportion of frailty (40%). Researchers observed that SLE vs OA was associated with a 2.74-fold increased risk for frailty (P =.002).

Risk for frailty was greater among participants who were overweight (OR, 1.98) and those with obesity (OR, 4.92; P <.001 for both) vs those who were normal weight.

“Future longitudinal analyses to determine factors associated with incident frailty and fractures are needed in this high-risk population,” the researchers concluded.

Reference

Wysham KD, Baker JF, Wipfler K, Katz PP, Michaud K. Prevalence of frailty and associated factors in a national observational cohort of rheumatic diseases. Presented at: ASBMR 2020 Virtual Annual Meeting; September 11-15, 2020; Poster #P-864.