Cognitive frailty and falls among Egyptian older adults with rheumatoid arthritis

Abstract

Background
Cognitive frailty is defined through a combination of physical frailty and cognitive impairment and is a growing concern in rheumatology. Rheumatoid arthritis is a lifelong disease, and the disease itself and the side effects of drug treatments may cause frailty. This study assessed the prevalence and risk factors for cognitive frailty and falls in people with rheumatoid arthritis.


Results
A cross-sectional study involving 105 rheumatoid arthritis patients (aged 60 and older) was performed. Each participant received a comprehensive medical history review. The Simplified Disease Activity Index (SDAI), the Montreal Cognitive Assessment, and the Frail Scale were assessed. Sixty-one patients (58.1%) exhibited mild cognitive impairment. Forty-eight (45.7%) were categorized as frail. Among the frail patients, 41 (85.4%) showed mild cognitive impairment. Cognitive frailty was observed in 41 patients (39%). Compared to prefrail patients, frail patients were older (mean age 68.98 ± 4.01 vs 63.54 ± 2.63; p < 0.0001), had a longer disease duration (33.00 ± 6.05 vs 26.77 ± 5.29; p < 0.0001), displayed higher disease activity (median SDAI 24 vs 10; p < 0.0001), and experienced a greater number of falls (2 vs 0; p < 0.0001).


Conclusion
Cognitive frailty is prevalent in RA patients. Age, level of education, disease duration, and disease severity are significant risk factors for frailty and cognitive impairment. RA patients who are frail are more prone to falls and therefore have a higher incidence of morbidity and adverse events.