Frailty in relation to psycho-social factors in elderly patients with rheumatoid arthritis: A cross-sectional mixed qualitative-quantitative study.
Frailty in relation to psycho-social factors in elderly patients with rheumatoid arthritis: A cross-sectional mixed qualitative-quantitative study.
复制标题
老年类风湿性关节炎患者与心理社会因素相关的虚弱：一项横断面混合定性定量研究。
DOI：
10.1111/1756-185x.14110
复制
发表时间：
2021-06
影响因子：
2.5
通讯作者：
van Onna M
中科院分区：
文献类型：
--
作者：
Cleutjens F;van Moerbeke A;Boonen A;van Onna M
本研究的目的是在≥55岁的类风湿性关节炎（RA）患者中探索：（1）通过格罗宁根虚弱指标（GFI）测量的虚弱发生率是否随年龄增加（调查1）;（2）深入了解哪些虚弱特征（例如，孤独）导致虚弱（调查2）。在3个年龄组（55 - 64/65 - 74/≥75岁）中评估了GFI，以确保平等的代表性。使用经验证的领域特异性问卷（例如医院焦虑和抑郁量表[HADS]）和半结构化访谈，在一个患者子集中进一步研究了GFI-最能区分被归类为虚弱患者的子域。问卷填写了两次：当前年龄和40岁时的回忆情况，看看精神病学是否可能被误解为虚弱。在纳入的90例患者中，各年龄组的GFI虚弱患病率分别为43.3%-40.0%-43.4%。虚弱患者经常报告抑郁（73.7%对11.5%）和焦虑（57.9%对15.4%）的感觉。有32/90例患者填写了两次心理社会问卷。在当前年龄（5/11例虚弱患者vs. 0/17例非虚弱患者，P = .01）和40岁（7/11例虚弱患者vs. 0/0例非虚弱患者，P < .01）时，更多虚弱患者在HADS上有焦虑障碍体征（缺失数据4例患者）。在访谈中，特别是虚弱的患者报告了沮丧的感觉，尽管没有人证实抑郁或焦虑。虚弱在≥55岁的RA患者中非常普遍。由于虚弱患者在当前年龄和（回忆）40岁时均表现出焦虑症状，因此这一发现表明先前存在的精神病学可能混淆虚弱评估。
The aim of the study was to explore in patients with rheumatoid arthritis (RA) ≥55 years: (1) whether the occurrence of frailty as measured by the Groningen Frailty Indicator (GFI) increases with age (survey 1); and (2) to gain insight into which frailty characteristics (eg, loneliness) contribute to frailty (survey 2). The GFI was assessed in 3 age groups (55‐64/65‐74/≥75‐years), ensuring equal representation. GFI‐subdomains that discriminated most between those classified as frail were further studied in a subset of patients using validated domain‐specific questionnaires (eg Hospital Anxiety and Depression Scale [HADS]) and semi‐structured interviews. Questionnaires were filled out twice: for current age and the recalled situation at age 40, to see whether psychiatric symptomatology might be misinterpreted for frailty. Of 90 patients included, frailty prevalence on the GFI across age groups was 43.3%‐40.0%‐43.4%, respectively. Frail patients often reported depressive (73.7% vs. 11.5%) and anxious (57.9% vs. 15.4%) feelings. There were 32/90 patients who filled out the psycho‐social questionnaires twice. More frail patients had signs of an anxiety disorder on the HADS (missing data 4 patients), both at current age (5/11 frail patients vs. 0/17 non‐frail patients, P = .01) and age 40 (7/11 frail patients vs. 0/0 non‐frail patients, P < .01). During the interviews, especially frail patients reported gloomy feelings, although none confirmed depression or anxiety. Frailty is highly prevalent in RA patients ≥55 years. As frail patients were characterized by symptoms of anxiety both at current age but (recalled) also at age 40, this finding suggests that pre‐existing psychiatric symptomatology may confound assessment of frailty.