Work

Frailty in rheumatoid arthritis and the general population: a cross-sectional analysis of the Groningen Frailty Indicator and Fried criteria

Year: 2026

Type: article

Abstract: OBJECTIVE: To compare frailty prevalence and factors driving frailty between older adults with RA and controls, using two conceptually distinct frailty instruments. METHODS: Cross-sectional data from the Studying Ageing in Rheumatoid Arthritis (STAR) study were used, including 207 patients with RA and 214 population controls aged 55-85 years. Frailty was assessed using the Groningen Frailty Indicator (GFI; 15 yes/no items; physical, cognitive, social, psychological domains; frail ≥ 4/15) in all participants and the Fried criteria (five yes/no items; physical domain; prefrail = 1-2, frail ≥ 3, and combined frail/prefrail ≥ 1 deficit) in a clinically assessed subgroup (RA: n = 88, controls: n = 96). Prevalence and overlap between instruments were described by group. Uni- and multivariable logistic (GFI: frailty vs robust) and Poisson (Fried: frail/prefrail vs robust) regressions assessed effects of age, group, the age*group interaction and additional covariates. RESULTS: Frailty prevalence was higher in RA than controls for GFI-frailty (34% vs 18%) and Fried-frailty/prefrailty (72% vs 50%). Among GFI-frail persons, 88% of patients with RA compared with 69% of controls were also frail or prefrail by Fried. Age was not associated with frailty in uni- or multivariable analyses for either instrument, in RA or controls (pinteraction age*group >0.10). The association with RA became insignificant after multivariable adjustment. Living alone, comorbidity score ≥1, higher fatigue and anxiety were associated with GFI-frailty, and higher BMI and poorer physical function with Fried-frailty/prefrailty. CONCLUSION: Older adults with RA show higher (pre)frailty prevalence than controls, which is associated with disease-related consequences and vulnerability rather than age, questioning the added value of frailty assessment beyond routine clinical evaluation.

Source: Lara D. Veeken

DOI: 10.1093/rheumatology/keag310

Authors: Saskia P M Truijen, Annelies Boonen, Sofia Ramiro, Marloes van Onna