Physical activity and nutritional profile assessment in elderly rheumatoid arthritis patients

Abstract

Background
Rheumatoid arthritis (RA) patients are at risk of malnutrition and physical inactivity, in particular elderly patients (≥ 65 years). This study aimed to evaluate the nutritional status and physical activity (PA) level in a sample of elderly RA patients and their correlation to functional capability and disease activity. The study included 100 RA patients and 100 apparently healthy volunteers as a control group of matching age and sex. All the participants were assessed for their nutritional status using the Mini Nutritional Assessment Short Form (MNA-SF) and body composition through electrical bioimpedance. PA level was assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF).


Results
There was a statistically significant difference between RA patients and the control group regarding fat mass (36.10 ± 5.93% vs 30.90 ± 7.95%; p = 0.0.034) and lean mass (21.73 ± 9.49 kg vs 29.90 ± 10.42 kg; p = 0.027) with RA patients had higher fat mass but lower lean mass than controls. For the nutritional status assessed by MNA-SF, there was a statistically significant difference between RA patients and the control group (11.57 ± 1.28 vs 13.70 ± 0.48; p = < 0.001) with (50%) of RA patients while only (4%) of the control group were at malnutrition risk. None of the participants were undernourished. There was a statistically significant difference between RA patients and the control group regarding PA assessed by IPAQ-SF (p = 0.007) with (50%) of RA patients having low, whereas (50%) of the control group had high IPAQ-SF. There was a highly significant negative correlation of MNA-SF with laboratory markers of inflammatory activity, different activity indices, and functional capability assessed by a modified health assessment questionnaire (MHAQ). Fat mass was positively correlated with age, while skeletal muscle mass and PAQ-SF were negatively correlated with MHAQ.


Conclusion
Elder patients with RA are more prone to impaired nutritional status either malnutrition or risk of malnutrition assessed by MNA and low PA levels assessed by IPAQ-SF. Moreover, they have higher fat mass but lower lean mass than controls as evaluated by electrical bioimpedance. In elder patients with RA, nutritional status is negatively correlated with laboratory markers of inflammatory activity, different activity indices, and functional impairment, whereas reduced PA levels are correlated with functional impairment.