Evaluating the Longitudinal Association of Rheumatoid Arthritis Disease Activity With Phenotypic Frailty: Evidence for Secondary Frailty?
Authors' conclusion
Disease activity is independently associated with phenotypic frailty. Increased disease activity over time is associated with worsening frailty status.
Study context
- Population
- Patients with rheumatoid arthritis (RA) in a longitudinal cohort at the Department of Veterans Affairs Puget Sound Health Care System (aged 64.2 ± 11.3 years; 73% male)n = 65 in longitudinal model
- Participants
- 132 patients
- Exposure
- DAS28-CRP vs frailty category at baseline and over one year
- Outcome
- Association between DAS28-CRP and frailty (FFP category: robust, prefrail, frail) over time
- Follow-up
- One year
Methodological detailslongitudinal, ordinal logistic regression, multivariable mixed ordinal logistic regression, adjusted for age, sex, disease duration, prednisone, csDMARD and bDMARD use
- Longitudinal
- Ordinal logistic regression
- Multivariable mixed ordinal logistic regression
- Adjusted for age, sex, disease duration, prednisone, csDMARD and bDMARD use
Main finding
As reported in the abstract
Higher frailty category over one year, per increase in DAS28-CRP
aOR for higher frailty category over one year with increased DAS28-CRP (n = 65)
3.31
P < 0.0001
Observational data: associations, not effects.
Further findings
Higher FFP category at baseline per 1-unit increase in DAS28-CRP (cross-sectional)
- aOR
- 1.98, P < 0.0001
DAS28-CRP change in those whose frailty score worsened · one year
- Mean ± SD change score
- 0.61 ± 0.96, P = 0.0121
- Paired t-test
Baseline DAS28-CRP and frailty distribution
- Mean ± SD baseline DAS28-CRP
- 3.9 ± 1.3
- Robust
- 35 (27%)
- Prefrail
- 77 (58%)
- Frail
- 20 (15%)
Original publication
Evaluating the Longitudinal Association of Rheumatoid Arthritis Disease Activity With Phenotypic Frailty: Evidence for Secondary Frailty? Arthritis Care Res (Hoboken). Published 9 December 2025. doi:10.
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