Frailty in rheumatoid arthritis: prevalence, fenotype signs and associated factors

Abstract

The aim – to establish the frequency of frailty and the ratio of its main phenotypic features in patients with rheumatoid arthritis (RA), as well as to identify associated factors. Material and methods. The study included 101 patients (86 women and 15 men) with RA at the age of 60 [52; 66] years; the average duration of the disease – 8 [3; 15] years. Frailty syndrome was diagnosed by the phenotypic model of L.P. Fried et al. In addition, the strength of the quadriceps femoris muscle was assessed using the test of getting up from a chair, functional status according to HAQ-DI (Health Assessment Questionnaire – Disability Index); Charlson comorbidity index, presence of cardiovascular disease (CVD); dementia severity and nutritional status. Factors associated with frailty were identified by the principal component method with the rotation of the correlation matrix using the Varimax raw method. Results. Frailty syndrome was detected in 40.6%, prefrailty in 55.4% of patients with RA, robust patients were 4.0%. The dominant signs of frailty in RA patients are reduced hand strength, fatigue, and weight loss. Four clusters of factors associated with frailty syndrome in RA have been identified: reduced hand strength, HAQ-DI impairment, and RA activity; reduced survival, comorbid cardiovascular disease and age; the total dose of glucocorticoids (GC) taken, an increase in walking time by 4 m and hypodynamia; eating disorders. Conclusion. Frailty and prefrailty dominate in patients with RA and have certain phenotypic features. Factors associated with frailty and it’s diagnostic features include impairment of vital activity, RA activity; premature mortality, CVD comorbidity, older age; taking GCS and malnutrition.