Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, New York, NY, USA; Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
Department of Veteran Affairs, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; Division of Rheumatology, Department of Medicine, University of Washington, Seattle, WA, USA.
Lancet Rheumatol. 2024 Dec;6(12):e881-e891. doi: 10.1016/S2665-9913(24)00191-7. Epub 2024 Nov 11.
Frailty represents a dynamic multisystem state of reduced physiological reserve that increases vulnerability to adverse health outcomes. Frailty occurs prematurely in adults with immune-mediated rheumatic diseases and is emerging as an important risk factor for adverse outcomes in these conditions. In this Series paper, we present a conceptual overview of frailty and its prevalence among patients with immune-mediated rheumatic diseases. We discuss putative mechanisms of frailty relevant to these diseases, tools for frailty measurement, and potential implications of frailty assessment for clinical care. We also explore the complex inter-relationship between frailty, inflammation, and disease activity in immune-mediated rheumatic diseases. As insight is gained into the epidemiology and mechanisms of frailty among patients with immune-mediated inflammatory rheumatic diseases, the possibility of targeting frailty with an intervention that could complement standard disease-modifying therapies to prevent adverse outcomes and improve health-related quality of life becomes closer to reality.
虚弱代表一种动态的多系统状态，表现为生理储备减少，使患者易发生不良健康后果。免疫介导性风湿病患者中虚弱的发生较为提前，并且虚弱已成为此类疾病不良结局的一个重要危险因素。在本系列论文中，我们对虚弱及其在免疫介导性风湿病患者中的流行情况进行了概念性概述。我们讨论了与这些疾病相关的虚弱的潜在机制、虚弱测量工具，以及虚弱评估对临床护理的潜在影响。我们还探讨了免疫介导性风湿病中虚弱、炎症和疾病活动之间复杂的相互关系。随着对免疫介导性炎症性风湿病患者中虚弱的流行病学和机制的深入了解，用干预措施靶向虚弱的可能性越来越大，这种干预措施可以补充标准的疾病修正治疗，以预防不良后果并提高与健康相关的生活质量。
