OP0265 FRAILTY, DISABILITY, AND WORK DISABILITY IN PEOPLE WITH OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS
Authors: Michael Cook, Suzanne Verstappen, Terence O’neill
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Frailty is a clinical syndrome associated with adverse health outcomes. Frailty and disability can co-occur though are distinct entities. There are few prospective data looking at the occurrence and development of frailty, disability, and work disability in people with osteoarthritis (OA) and rheumatoid arthritis (RA). <h3>Objectives</h3> To determine the odds of prevalent and incident frailty, disability, and work disability in people with OA or RA, compared to people without these diseases. <h3>Methods</h3> Subjects aged 40-69 were recruited to the UK Biobank cohort. Data, including self-reported physician-diagnosed OA and RA, were collected at baseline (2007-10) and, in a subset, at follow up (2012-16). Frailty was measured using a modified Fried phenotype comprising five components: self-reported weight loss, exhaustion, low physical activity, slow usual walking pace, and low measured grip-strength (1). Participants were classified as robust if none of the components were present, pre-frail if 1-2 components were present and frail if ≥3 components were present. Participants were classified as having a disability if they indicated receiving a disability allowance/benefit. Participants indicating that they were unable to work due to disability or illness were classified as work disabled. Incident frailty was defined as frail at follow up and robust or pre-frail at baseline. Incident disability or work disability, respectively was defined as receiving a disability benefit or indicating work disability at follow up but not at baseline. <h3>Results</h3> The mean (SD) age of the 465,379 participants at baseline was 56.5 (8.1) years and 54.3% were female. At baseline, 8.0% of the cohort reported that they had OA and 1.1% RA. At baseline, the prevalence of pre-frailty and frailty was 45.9% and 3.1%, respectively. 3.4% of the cohort indicated receiving a disability benefit, and 3.6% being work disabled. In a model adjusted for age, sex, smoking status and deprivation, compared to those without OA, those with OA were more likely to be pre-frail, odds ratio (OR) (95% CI), 1.8 (1.7,1.8), or frail, OR 4.5 (4.3,4.7), than robust. The adjusted OR (95% CI) for pre-frailty and frailty in those with RA (vs no RA) was 2.8 (2.6, 3.0) and 10.6 (9.7, 11.6), respectively. The adjusted OR (95% CI) for disability benefit was 3.9 (3.8, 4.1) in people with OA (vs no OA) and 7.7 (7.2, 8.2) in people with RA (vs no RA). The adjusted OR (95% CI) for work disability at baseline was 3.5 (3.3, 3.6) in people with OA and 4.8 (4.4, 5.2) in people with RA. Data were available for 26,932 participants at follow up. The mean (SD) follow up time was 5.3 (1.5) years. Of those without frailty at baseline, 573 participants developed frailty during follow up. There were 292 incident cases of disability benefit and 137 incident cases of work disability. The adjusted OR (95% CI) for incident frailty in people with OA and RA at baseline was 2.3 (1.8, 2.9) and 3.3 (1.9, 5.7), respectively. The adjusted OR (95% CI) for incident disability benefit in people with OA and RA at baseline, was 2.7 (2.0, 3.6) and 3.2, (1.7, 6.2), respectively. The adjusted OR (95% CI) for incident work disability in people with OA and RA at baseline was 2.3 (1.3, 3.9) and 3.7 (1.3, 10.1), respectively. <h3>Conclusion</h3> People with OA and RA have an increased risk of being, or becoming, frail, disabled, or work disabled. Further work is needed to determine effective strategies for preventing or delaying the occurrence of frailty, disability, and work disability in people with OA and RA. <h3>References</h3> [1] Hanlon P, Nicholl BI, Jani BD, Lee D, McQueenie R, Mair FS. Frailty and pre-frailty in middle-aged and older adults and its association with multimorbidity and mortality: A prospective analysis of 493 737 UK biobank participants. The Lancet Public health 2018;3:e323-e32 <h3>Disclosure of Interests</h3> None declared