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Rheumatoid Arthritis

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

, , , , , , , , , , , , , & show all
Pages 979-986 | Received 10 Jul 2020, Accepted 13 Oct 2020, Published online: 02 Nov 2020
 

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.

Acknowledgments

The authors would like to thank the patients who participated in this study, and Ms. Kamiji, Ms. Mizutani, Ms. Ohya, and Ms. Okajima for their contribution to the acquisition of data.

Conflict of interest

None.

Additional information

Funding

This work was supported by JSPS KAKENHI Grant Numbers [JP26460608, JP20H03954], and the Research Funding for Longevity Sciences from National Center for Geriatrics and Gerontology, Japan (19–51).

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