Prevalence of Frailty and Associated Factors in a US‐Wide Cohort of Rheumatic Diseases

Objective We quantified the prevalence of self‐reported frailty and identified associated factors in a US‐wide cohort of people with rheumatic and musculoskeletal diseases (RMDs). Methods Frailty was measured using the FRAIL scale, a patient‐reported frailty instrument, in FORWARD, The US‐based Nati...

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Main Authors: Katherine D. Wysham, Catherine L. A. Chang, Namrata Singh, James S. Andrews, Kristin Wipfler, Sarah B. Lieber, Sebastian E. Sattui, Rachael Stovall, Joshua F. Baker, Patricia P. Katz, Kaleb Michaud
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:ACR Open Rheumatology
Online Access:https://doi.org/10.1002/acr2.70046
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author Katherine D. Wysham
Catherine L. A. Chang
Namrata Singh
James S. Andrews
Kristin Wipfler
Sarah B. Lieber
Sebastian E. Sattui
Rachael Stovall
Joshua F. Baker
Patricia P. Katz
Kaleb Michaud
author_facet Katherine D. Wysham
Catherine L. A. Chang
Namrata Singh
James S. Andrews
Kristin Wipfler
Sarah B. Lieber
Sebastian E. Sattui
Rachael Stovall
Joshua F. Baker
Patricia P. Katz
Kaleb Michaud
author_sort Katherine D. Wysham
collection DOAJ
description Objective We quantified the prevalence of self‐reported frailty and identified associated factors in a US‐wide cohort of people with rheumatic and musculoskeletal diseases (RMDs). Methods Frailty was measured using the FRAIL scale, a patient‐reported frailty instrument, in FORWARD, The US‐based National Databank for Rheumatic Diseases. Frailty prevalence was determined overall and by individual RMD, which included rheumatoid arthritis, connective tissue diseases (CTDs), osteoarthritis (OA), fibromyalgia, spondyloarthritis (SpA), and vasculitis. Multivariable logistic regression models evaluated the cross‐sectional associations between RMDs and frailty, as well as factors associated with frailty within each RMD. Results Among 4,345 individuals, 1,422 were frail (33%). Participants were on average 67.1 ± 11.6 years of age, 82% were female, and 89% self‐identified as White. Difficulty with ambulation was the most common frailty feature. With OA as referent, those with CTD had a higher odds of frailty (odds ratio [OR] 1.44, 95% confidence interval [CI] 1.01–2.04), and those with SpA had a lower odds (OR 0.45, 95% CI 0.31–0.67). Age, female sex, pain, disease severity, disease duration, and elevated body mass index categories were all associated with frailty. In the RMD‐stratified analyses, disease severity remained associated with frailty in all RMDs except vasculitis. Conclusion Frailty was present in 1 in 3 participants with RMDs, a higher prevalence than estimates from the general population, and primarily manifests as difficulty with mobility. Disease severity was consistently associated with an increased odds of frailty across RMDs. Future interventions to improve physical activity and prevent disease damage may improve frailty status in people with RMDs.
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spelling doaj-art-afe5c4136f7a4e8291ddaa82b5d12ff62025-08-20T03:55:49ZengWileyACR Open Rheumatology2578-57452025-06-0176n/an/a10.1002/acr2.70046Prevalence of Frailty and Associated Factors in a US‐Wide Cohort of Rheumatic DiseasesKatherine D. Wysham0Catherine L. A. Chang1Namrata Singh2James S. Andrews3Kristin Wipfler4Sarah B. Lieber5Sebastian E. Sattui6Rachael Stovall7Joshua F. Baker8Patricia P. Katz9Kaleb Michaud10VA Puget Sound Health Care System, Puget Sound Geriatric Research Education and Clinical Center, and University of Washington SeattleUniversity of Washington SeattleUniversity of Washington SeattleUniversity of Alabama at BirminghamFORWARD, The National Databank for Rheumatic Diseases Wichita KansasHospital for Special Surgery and Weill Cornell Medicine New York City New YorkUniversity of Pittsburgh Pittsburg PennsylvaniaUniversity of Washington SeattleCorporal Michael J. Crescenz VA Medical Center and University of Pennsylvania PhiladelphiaUniversity of California San FranciscoFORWARD, The National Databank for Rheumatic Diseases, Wichita, Kansas and University of Nebraska Medical Center OmahaObjective We quantified the prevalence of self‐reported frailty and identified associated factors in a US‐wide cohort of people with rheumatic and musculoskeletal diseases (RMDs). Methods Frailty was measured using the FRAIL scale, a patient‐reported frailty instrument, in FORWARD, The US‐based National Databank for Rheumatic Diseases. Frailty prevalence was determined overall and by individual RMD, which included rheumatoid arthritis, connective tissue diseases (CTDs), osteoarthritis (OA), fibromyalgia, spondyloarthritis (SpA), and vasculitis. Multivariable logistic regression models evaluated the cross‐sectional associations between RMDs and frailty, as well as factors associated with frailty within each RMD. Results Among 4,345 individuals, 1,422 were frail (33%). Participants were on average 67.1 ± 11.6 years of age, 82% were female, and 89% self‐identified as White. Difficulty with ambulation was the most common frailty feature. With OA as referent, those with CTD had a higher odds of frailty (odds ratio [OR] 1.44, 95% confidence interval [CI] 1.01–2.04), and those with SpA had a lower odds (OR 0.45, 95% CI 0.31–0.67). Age, female sex, pain, disease severity, disease duration, and elevated body mass index categories were all associated with frailty. In the RMD‐stratified analyses, disease severity remained associated with frailty in all RMDs except vasculitis. Conclusion Frailty was present in 1 in 3 participants with RMDs, a higher prevalence than estimates from the general population, and primarily manifests as difficulty with mobility. Disease severity was consistently associated with an increased odds of frailty across RMDs. Future interventions to improve physical activity and prevent disease damage may improve frailty status in people with RMDs.https://doi.org/10.1002/acr2.70046
spellingShingle Katherine D. Wysham
Catherine L. A. Chang
Namrata Singh
James S. Andrews
Kristin Wipfler
Sarah B. Lieber
Sebastian E. Sattui
Rachael Stovall
Joshua F. Baker
Patricia P. Katz
Kaleb Michaud
Prevalence of Frailty and Associated Factors in a US‐Wide Cohort of Rheumatic Diseases
ACR Open Rheumatology
title Prevalence of Frailty and Associated Factors in a US‐Wide Cohort of Rheumatic Diseases
title_full Prevalence of Frailty and Associated Factors in a US‐Wide Cohort of Rheumatic Diseases
title_fullStr Prevalence of Frailty and Associated Factors in a US‐Wide Cohort of Rheumatic Diseases
title_full_unstemmed Prevalence of Frailty and Associated Factors in a US‐Wide Cohort of Rheumatic Diseases
title_short Prevalence of Frailty and Associated Factors in a US‐Wide Cohort of Rheumatic Diseases
title_sort prevalence of frailty and associated factors in a us wide cohort of rheumatic diseases
url https://doi.org/10.1002/acr2.70046
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