FRI0060 Are older ra patients frail, or lonely and depressed?

Abstract

Background The average rheumatoid arthritis (RA) patient has approximately 2 comorbidities, and this number increases with age. Both comorbidity and ageing are considered risk factors for frailty, a physiological syndrome characterised by reduced functional reserves and resistance to ‘stressors’ due to a cumulative decline of physiological and psychosocial systems. Frailty results in adverse health outcomes including hospitalisation and increased risk of mortality. The extent to which frailty is a relevant problem in elderly RA patients remains unknown. Objectives (1) To assess the prevalence of frailty and (2) to identify which factors are associated with frailty in elderly patients with RA. Methods Consecutive patients of the outpatient clinic where invited to participate in a study on ageing while ensuring equal representation of patients in three pre-defined age groups: 55–64, 65–74, and ≥75 years. Rheumatologists recorded the number of comorbidities. Patients rated their overall health on a visual analogue scale (0–100; 100 very bad health) and completed the validated Groningen Frailty Indicator (GFI), which contains 15 questions on the loss of functions and resources across 4 domains: physical (mobility functions, multiple health problems, physical fatigue, vision, hearing), cognitive (cognitive dysfunction), social (emotional isolation), and psychological (depressed mood and feelings of anxiety). Scores on items are dichotomized, “1”; indicating a problem or dependency. Prevalence of problems/dependency was compared among the 3 age-groups using a Kruskal-Wallis test. Characteristics of patients classified as frail (GFI score ≥4) or non-frail (GFI score <4) were compared using a chi-square test for categorical data or the independent samples t-test for continuous data. Results The prevalence of frailty across age groups was respectively 43.3%. 40.0% and 43.4%. Frail RA patients were more often female, had a lower subjective health status. Remarkable, patients classified as frail identified problems in the social and psychosocial domains. Of interest, there were no differences regarding age, polypharmacy, number of comorbidities, and cognitive domain (figure 1). View this table: Table 1 Comparison of demographics, clinical characteristics, and number of patients with problems/dependency per frailty domain between frail and non-frail elderly rheumatoid arthritis patients.![][1] Conclusions Using validated questionnaires, frailty is highly prevalent in all RA patients older than 55 years and seems to be a distinctive health construct which is not necessarily related to increasing age, polypharmacy and comorbidity in patients with RA. An alternative explanation of our findings is that rheumatologists seem to miss symptoms of depression and loneliness among RA patients. Disclosure of Interest None declared [1]: /embed/graphic-1.gif