Frailty in rheumatoid arthritis and its relationship with disease activity, hospitalisation and mortality: a longitudinal analysis of the Scottish Early Rheumatoid Arthritis cohort and UK Biobank (original) (raw)

Hanlon, Peter ORCID: https://orcid.org/0000-0002-5828-3934, Morton, Fraser ORCID: https://orcid.org/0000-0001-5328-9467, Siebert, Stefan ORCID: https://orcid.org/0000-0002-1802-7311, Jani, Bhautesh D. ORCID: https://orcid.org/0000-0001-7348-514X, Nicholl, Barbara I. ORCID: https://orcid.org/0000-0001-5639-0130, Lewsey, Jim ORCID: https://orcid.org/0000-0002-3811-8165, McAllister, David ORCID: https://orcid.org/0000-0003-3550-1764 and Mair, Frances S. ORCID: https://orcid.org/0000-0001-9780-1135(2022) Frailty in rheumatoid arthritis and its relationship with disease activity, hospitalisation and mortality: a longitudinal analysis of the Scottish Early Rheumatoid Arthritis cohort and UK Biobank.RMD Open, 8(1), e002111. (doi: 10.1136/rmdopen-2021-002111) (PMID:35292529) (PMCID:PMC8928366)

Abstract

Objective: To assess the prevalence of frailty in rheumatoid arthritis (RA) and its association with baseline and longitudinal disease activity, all-cause mortality and hospitalisation. Participants: People with RA identified from the Scottish Early Rheumatoid Arthritis (SERA) inception cohort (newly diagnosed, mean age 58.2 years) and UK Biobank (established disease identified using diagnostic codes, mean age 59 years). Frailty was quantified using the frailty index (both datasets) and frailty phenotype (UK Biobank only). Disease activity was assessed using Disease Activity Score in 28 joints (DAS28) in SERA. Associations between baseline frailty and all-cause mortality and hospitalisation was estimated after adjusting for age, sex, socioeconomic status, smoking and alcohol, plus DAS28 in SERA. Results: Based on the frailty index, frailty was common in SERA (12% moderate, 0.2% severe) and UK Biobank (20% moderate, 3% severe). In UK Biobank, 23% were frail using frailty phenotype. Frailty index was associated with DAS28 in SERA, as well as age and female sex in both cohorts. In SERA, as DAS28 lessened over time with treatment, mean frailty index also decreased. The frailty index was associated with all-cause mortality (HR moderate/severe frailty vs robust 4.14 (95% CI 1.49 to 11.51) SERA, 1.68 (95% CI 1.26 to 2.13) UK Biobank) and unscheduled hospitalisation (incidence rate ratio 2.27 (95% CI 1.45 to 3.57) SERA 2.74 (95% CI 2.29 to 3.29) UK Biobank). In UK Biobank, frailty phenotype also associated with mortality and hospitalisation. Conclusion: Frailty is common in early and established RA and associated with hospitalisation and mortality. Frailty in RA is dynamic and, for some, may be ameliorated through controlling disease activity in early disease.

University Staff: Request a correction | Enlighten Editors: Update this record

Funder and Project Information

Understanding prevalence and impact of frailty in chronic illness and implications for clinical management

Frances Mair

MR/S021949/1

HW - General Practice and Primary Care

Multimorbidity in Arthritis and persistent musculoskeletal Pain (MAP) Study

Barbara Nicholl

Ref: 21970

HW - General Practice and Primary Care

Deposit and Record Details