Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, New York, NY, USA.
Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
Rheumatology (Oxford). 2024 May 2;63(5):1384-1390. doi: 10.1093/rheumatology/kead393.
Frailty is a risk factor for adverse health in SLE. The Fried phenotype (FP) and the SLICC Frailty Index (SLICC-FI) are common frailty metrics reflecting distinct approaches to frailty assessment. We aimed to (1) compare frailty prevalence according to both metrics in women with SLE and describe differences between frail and non-frail participants using each method and (2) evaluate for cross-sectional associations between each metric and self-reported disability.
Women aged 18-70 years with SLE were enrolled. FP and SLICC-FI were measured, and agreement calculated using a kappa statistic. Physician-reported disease activity and damage, Patient Reported Outcome Measurement Information System (PROMIS) computerized adaptive tests, and Valued Life Activities (VLA) self-reported disability were assessed. Differences between frail and non-frail participants were evaluated cross-sectionally, and the association of frailty with disability was determined for both metrics.
Of 67 participants, 17.9% (FP) and 26.9% (SLICC-FI) were frail according to each metric (kappa = 0.41, P < 0.01). Compared with non-frail women, frail women had greater disease damage, worse PROMIS scores, and greater disability (all P < 0.01 for FP and SLICC-FI). After age adjustment, frailty remained associated with a greater odds of disability [FP: odds ratio (OR) 4.7, 95% CI 1.2, 18.8; SLICC-FI: OR 4.6, 95% CI 1.3, 15.8].
Frailty is present in 17.9-26.9% of women with SLE. These metrics identified a similar, but non-identical group of women as frail. Further studies are needed to explore which metric is most informative in this population.
衰弱是 SLE 患者不良健康的危险因素。弗莱德表型（FP）和 SLICC 衰弱指数（SLICC-FI）是常见的衰弱衡量标准，反映了评估衰弱的不同方法。我们旨在：（1）比较两种指标在 SLE 女性中的衰弱患病率，并使用每种方法描述衰弱和非衰弱参与者之间的差异；（2）评估两种指标与自我报告残疾之间的横断面相关性。
纳入年龄在 18-70 岁之间的 SLE 女性。测量 FP 和 SLICC-FI，并使用 Kappa 统计计算一致性。评估医生报告的疾病活动和损伤、患者报告的结局测量信息系统（PROMIS）计算机自适应测试以及有价值的生活活动（VLA）自我报告的残疾。评估衰弱和非衰弱参与者之间的差异，并确定两种指标与残疾的相关性。
在 67 名参与者中，根据每个指标，17.9%（FP）和 26.9%（SLICC-FI）为衰弱（kappa=0.41，P<0.01）。与非衰弱女性相比，衰弱女性的疾病损伤更大，PROMIS 评分更差，残疾程度更大（FP 和 SLICC-FI 均为 P<0.01）。调整年龄后，衰弱仍然与残疾的可能性增加相关[FP：比值比（OR）4.7，95%可信区间（CI）1.2，18.8；SLICC-FI：OR 4.6，95% CI 1.3，15.8]。
在 SLE 女性中，17.9%-26.9%存在衰弱。这两种指标确定了一组相似但不相同的衰弱女性。需要进一步研究来探讨哪种指标在该人群中最具信息性。
