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. 2023;12(3):247-251.
doi: 10.14283/jfa.2023.24.

Association of Baseline Frailty with Patient-Reported Outcomes in Systemic Lupus Erythematosus at 1 Year

S B Lieber  1 , M Nahid, M Rajan, M Barbhaiya, L Sammaritano, R A Lipschultz, M Lin, M C Reid, L A Mandl
Affiliations

Association of Baseline Frailty with Patient-Reported Outcomes in Systemic Lupus Erythematosus at 1 Year

S B Lieber et al. J Frailty Aging. 2023.

Abstract

The relationship of baseline frailty with subsequent patient-reported outcomes in systemic lupus erythematosus (SLE) remains unclear. We assessed these associations in a pilot prospective cohort study. Frailty based on the FRAIL scale and the Fried phenotype and patient-reported outcomes, namely Patient Reported Outcomes Measurement Information System computerized adaptive tests and Valued Life Activities disability, were measured at baseline and 1 year among women aged 18-70 years with SLE enrolled at a single center. Differences in Patient Reported Outcomes Measurement Information System computerized adaptive tests between frail and non-frail participants were evaluated using Wilcoxon rank sum tests, and the association of baseline frailty with self-report disability at 1 year was estimated using linear regression. Of 51 participants, 24% (FRAIL scale) and 16% (Fried phenotype) met criteria for frailty at baseline despite median age of 55.0 and 56.0 years, respectively. Women with (versus without) baseline frailty using either measure had worse 1-year Patient Reported Outcomes Measurement Information System computerized adaptive test scores across multiple domains and greater self-report disability. Baseline frailty was significantly associated with self-report disability at 1 year (FRAIL scale: parameter estimate 0.55, 95% confidence interval (CI) 0.21-0.89, p<0.01; Fried phenotype: parameter estimate 0.61, 95% CI 0.22-1.00, p<0.01), including only slight attenuation after adjustment for SLE cumulative organ damage (FRAIL scale: parameter estimate 0.45, 95% CI 0.09-0.81, p=0.02; Fried phenotype: parameter estimate 0.49, 95% CI 0.09-0.90, p=0.02). These preliminary findings support frailty as an independent risk factor for clinically relevant patient-reported outcomes, including disability onset, among women with SLE.

Keywords: Frailty; health-related quality of life; patient-reported outcome measures; systemic lupus erythematosus.

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Conflict of interest statement

Dr. Mandl discloses research grants from Regeneron Pharmaceuticals, royalties from UpToDate, and salary support from Annals of Internal Medicine.

References

    1. Tsokos GC, Systemic lupus erythematosus. N Engl J Med, 2011. 365(22): p. 2110–21. - PubMed
    1. Bandeen-Roche K, et al., Phenotype of frailty: characterization in the women’s health and aging studies. J Gerontol A Biol Sci Med Sci, 2006. 61(3): p. 262–6. - PubMed
    1. Morley JE, Malmstrom TK, and Miller DK, A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging, 2012. 16(7): p. 601–8. - PMC - PubMed
    1. Legge A, et al., Evaluating the Properties of a Frailty Index and Its Association With Mortality Risk Among Patients With Systemic Lupus Erythematosus. Arthritis Rheumatol, 2019. 71(8): p. 1297–1307. - PMC - PubMed
    1. Legge A, et al., Construction of a Frailty Index as a Novel Health Measure in Systemic Lupus Erythematosus. J Rheumatol, 2020. 47(1): p. 72–81. - PMC - PubMed