The utility of 25-question Geriatric Locomotive Function Scale for evaluating functional ability and disease activity in Japanese rheumatoid arthritis patients: A cross-sectional study using NinJa database

Abstract

Objectives: To investigate the distribution of 25-question Geriatric Locomotive Function Scale (GLFS-25) scores in Japanese rheumatoid arthritis (RA) patients and evaluate relationships with clinical variables.

Methods: Among 15,115 patients registered in the NinJa database for fiscal year 2015, 1710 with complete GLFS-25 and disease activity score-28 (DAS28) data were analyzed. Correlations between GLFS-25 score and clinical variables were assessed by Spearman coefficients. Mean GLFS-25 scores were compared among DAS28 groups (<2.6, 2.6−3.1, 3.2−5.0, ≥5.1) using the Kruskal–Wallis test. To evaluate the performance of the GLFS-25 and Health Assessment Questionnaire Disability Index (HAQ-DI) for predicting DAS28 ≥ 3.2 (moderate/high disease activity), receiver operator characteristic (ROC) curves were constructed.

Results: GLFS-25 score was significantly correlated with age, disease duration, DAS28, and HAQ-DI. GLFS-25 score increased in parallel with DAS28. The proportion of patients with locomotive syndrome stage 2 also increased with DAS28. Area under the curve values for HAQ-DI and GLFS-25 score were 0.739 and 0.768, respectively. At a GLFS-25 positive cutoff score ≥16, sensitivity was 0.716 and specificity was 0.661 for predicting DAS28 ≥ 3.2.

Conclusion: This study documents the GLFS-25 score distribution in Japanese RA patients and demonstrates that GLFS-25 is a useful measure for evaluating functional ability in RA.

Keywords:

• ADL
• GLFS-25
• locomotive syndrome
• physical function
• rheumatoid arthritis

Acknowledgements

The authors thank Mayumi Yokoyama, who provided expert technical assistance. The authors acknowledge the assistance of the following clinicians who referred patients to NinJa: Kumiko Akiya, Tomiaki Asai, Noriyuki Chiba, Yoshito Eto, Kenji Ichikawa, Atsushi Kaneko, Yojiro Kawabe, Toshihiro Matusi, Kinori Matsumori, Ryutaro Matsumura, Satoru Motokawa, Kunikazu Ogawa, Akira Okamoto, Koichiro Omura, Yusuke Ota, Yukihiko Saeki, Koichiro Saisho, Tomotaro Sato, Yoshiki Shinohara, Makoto Sueishi, Eichi Suematu, Yasuo Suenaga, Shoji Sugii, Takao Sugiyama, Koichiro Takashi, Norio Tamura, Kaeharu Tonai, Issaku Toyohara, Hiroshi Tsutani, Hajime Yamagata, Hidetoshi Yanagida, Masyuki Yasuda, Yasuhiko Yoshinaga, and Shigeru Yoshizawa. The authors would like to thank Enago for the English language review.

Conflict of interest

None.

Additional information

Funding

This work was supported in part by Health and Labour Sciences Research Grants from Ministry of Health, Labour and Welfare, Japan to Shigeto Tohma.