Hanlon, P. , Morrison, H., Morton, F. , Jani, B. D. , Siebert, S. , Lewsey, J. , McAllister, D. and Mair, F. S. (2022) Frailty in people with rheumatoid arthritis: a systematic review of observational studies. Wellcome Open Research, 6, 244. (doi: 10.12688/wellcomeopenres.17208.2)
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Abstract
Background: Frailty, an age-related decline in physiological reserve, is an increasingly important concept in the management of chronic diseases. The implications of frailty in people with rheumatoid arthritis are not well understood. We undertook a systematic review to assess the prevalence of frailty in people with rheumatoid arthritis, and the relationship between frailty and clinical outcomes. Methods: We searched three electronic databases (January 2001 to April 2021) for observational studies assessing the prevalence of frailty in adults (≥18 years) with rheumatoid arthritis, or analysing the relationship between frailty and clinical outcomes in the context of rheumatoid arthritis. Titles, abstracts and full texts were assessed independently by two reviewers. Study quality was assessed using an adapted Newcastle-Ottawa Scale. Results: We identified 17 analyses, from 14 different sample populations. 15/17 were cross-sectional. These studies used 11 different measures of frailty. Frailty prevalence ranged from 10% (frailty phenotype) to 36% (comprehensive rheumatologic assessment of frailty) in general adult populations with rheumatoid arthritis. In younger populations (<60 or <65 years) prevalence ranged from 2.4% (frailty phenotype) to 19.9% (Kihon checklist) while in older populations (>60 or >65) prevalence ranged from 31.2% (Kihon checklist) to 55% (Geriatric 8 tool). Frailty was associated with higher disease activity (10/10 studies), lower physical function (7/7 studies), longer disease duration (2/5 studies), hospitalization (1/1 study) and osteoporotic fractures (1/1 study). Conclusion: Our review found that frailty is common in adults with rheumatoid arthritis, including those aged <65 years, and is associated with a range of adverse features. However, these is substantial heterogeneity in how frailty is measured in rheumatoid arthritis. We found a lack of longitudinal studies making the impact of frailty on clinical outcomes over time and the extent to which frailty is caused by rheumatoid arthritis unclear.
| Item Type: | Articles |
|---|---|
| Additional Information: | Version 2; peer review: 1 approved, 1 approved with reservations. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Jani, Dr Bhautesh and McAllister, Professor David and Morrison, Dr Holly and Hanlon, Dr Peter and Lewsey, Professor Jim and Siebert, Professor Stefan and Mair, Professor Frances and Morton, Mr Fraser |
| Creator Roles: | Hanlon, P.Conceptualization, Formal analysis, Funding acquisition, Investigation, Methodology, Visualization, Writing – original draft, Writing – review and editing Morrison, H.Investigation, Writing – review and editing Morton, F.Writing – review and editing Jani, B. D.Writing – review and editing Siebert, S.Writing – review and editing Lewsey, J.Conceptualization, Investigation, Methodology, Supervision, Writing – review and editing McAllister, D.Conceptualization, Investigation, Methodology, Supervision, Writing – review and editing Mair, F. S.Conceptualization, Investigation, Methodology, Supervision, Writing – review and editing |
| Authors: | Hanlon, P., Morrison, H., Morton, F., Jani, B. D., Siebert, S., Lewsey, J., McAllister, D., and Mair, F. S. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health College of Medical Veterinary and Life Sciences > School of Infection & Immunity College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
| Research Centre: | College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Immunobiology |
| Journal Name: | Wellcome Open Research |
| Publisher: | F1000Research |
| ISSN: | 2398-502X |
| ISSN (Online): | 2398-502X |
| Published Online: | 23 September 2021 |
| Copyright Holders: | Copyright © 2021 Hanlon P et al. |
| First Published: | First published in Wellcome Open Research 6: 244 |
| Publisher Policy: | Reproduced under a Creative Commons License |
| Data DOI: | 10.5281/zenodo.5515860 |
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