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日本类风湿关节炎患者衰弱的临床特征

Clinical Characteristics of frailty in Japanese Rheumatoid Arthritis Patients.

作者信息

Yoshii I, Kondo M

机构信息

Ichiro Yoshii, Yoshii Hospital, Shimanto-City, Kochi Prefecture Japan,

出版信息

J Frailty Aging. 2020;9(3):158-164. doi: 10.14283/jfa.2020.1.

Abstract

OBJECTIVE

The relationship between clinical characteristics and frailty was investigated in rheumatoid arthritis (RA) patients >40 years old.

METHODS

RA patients followed for >1 year were interviewed and diagnosed as frail according to a 5-item frailty score index: (1) weight loss >2 kg within 6 months (WL); (2) slower gait speed (GS); (3) exercise less than once per week (EX); (4) decline in short-term memory (SM); and (5) general fatigue in the past 2 weeks (GF). The relationship between frailty status and background parameters was evaluated.

RESULTS

Among 739 subjects, frail patients comprised 221, pre-frail patients comprised 203, and robust comprised 315. The most common symptom in the Frailty group was GS, followed by SM, GF, EX, and WL, whereas the most common symptom in the Pre-frailty group was GS followed by SM, GF, WL, and EX. Frailty was significantly correlated with aging. Elderly onset rheumatoid arthritis, disease activity, serum C-reactive protein concentration, degree of joint deformity, activities in daily living (ADL), dementia treated, and glucocorticoid steroid administration demonstrated significant correlations with frailty status, although all factors also demonstrated significant correlation with aging. In addition, the EuroQol score (EQ5D) was significantly correlated with both aging and frailty.

CONCLUSION

The results suggest that a remission state for disease activity, ADL, and dementia is correlated with frailty. The most common and primary symptom is GS. Elderly RA patients require careful attention for symptoms of frailty, which may damage the EQ5D score, specifically, the quality of life for RA patients.

摘要

目的

研究年龄大于40岁的类风湿关节炎(RA)患者的临床特征与衰弱之间的关系。

方法

对随访时间超过1年的RA患者进行访谈,并根据5项衰弱评分指数诊断为衰弱:(1)6个月内体重减轻>2 kg(WL);(2)步态速度减慢(GS);(3)每周锻炼少于1次(EX);(4)短期记忆力下降(SM);(5)过去2周内全身疲劳(GF)。评估衰弱状态与背景参数之间的关系。

结果

在739名受试者中,衰弱患者221名,衰弱前期患者203名,健康者315名。衰弱组最常见的症状是GS,其次是SM、GF、EX和WL,而衰弱前期组最常见的症状是GS,其次是SM、GF、WL和EX。衰弱与衰老显著相关。老年发病的类风湿关节炎、疾病活动度、血清C反应蛋白浓度、关节畸形程度、日常生活活动能力(ADL)、治疗的痴呆症以及糖皮质激素的使用与衰弱状态均显著相关,尽管所有这些因素也与衰老显著相关。此外,欧洲五维健康量表(EQ5D)评分与衰老和衰弱均显著相关。

结论

结果表明,疾病活动度、ADL和痴呆症的缓解状态与衰弱相关。最常见和主要的症状是GS。老年RA患者需要密切关注衰弱症状,这可能会损害EQ5D评分,特别是RA患者的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4085/12275781/6d08f101d487/gr1.jpg

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