AB0339 Sarcopenia and early frailty syndrome in rheumatoid arthritis
Authors: E. Trujillo, M.R. Garcia-Marrero, M.I. Fuentes, M.D.M. Trujillo
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Sarcopenia and frailty are common in older persons and pose particular challenges for health and social care systems. Sarcopenia, the loss of skeletal muscle mass, is a core component of physical frailty that together impact negatively on an individual's capability to live independently. Frailty is defined as a syndrome of physiological decline in late life, characterised by marked vulnerability to adverse health outcomes. Frail adults are less able to adapt to stressors such as acute illness or trauma than non-frail adults. This increased vulnerability contributes to increased risk for multiple adverse outcomes, including procedural complications, falls, institutionalisation, disability, and death. Rheumatoid arthritis (RA) is a chronic disabling disease, which leads to functional limitations and diminishes health-related quality of life. The presence of comorbidity and polypharmacy are both related to RA severity. <h3>Objectives</h3> The aim of this study was to assess the prevalence of sarcopenia and frailty syndrome in patients with RA. <h3>Methods</h3> Cross-sectional, observational and descriptive study in patients with RA (ACR criteria) older than 50 years. Sarcopenia was defined as per the European Working Group on Sarcopenia in Older People definition as Skeletal muscle mass index (SMI) ≤8.87 kg/m<sup>2</sup> in men and ≤6.42 kg/m<sup>2</sup> in women. Body composition analysis was performed using bioelectrical impedance analysis (BIA). Fragility was measured according to the 5 criteria proposed by Fried, using the Frail scale, and it was considered fragile to the patient who met at least 3 and prefragiles to those who met at least 2. Frail scale: Based on five items, reflecting performance, selfreports and common co-morbidities (<i>Morley JE et al. J Nutr Health Ageing 2012;16(7):601–8</i>). FRAIL SCALE Did you feel worn out? or Did you feel tired? Ability to climb one flight of stairs Ability to walk 100 m Self-report of &gt;5% wt loss ≤5 of: dementia; heart Disease; depression; arthritis; asthma; bronchitis/emphysema; diabetes; hypertension; osteoporosis; stroke. <h3>Results</h3> 283 consecutive RA patients were included, 83.4%) were female. Mean age was 63.3 years and mean disease duration was 10.4 years. Mean number of comorbidities was 1.48, with systemic hypertension and obesity as the most frequent ones (33.8% and 26.4%, respectively). Polypharmacy was found in 96.8% and 64.7% received more than five drugs simultaneously. 31% presented some degree of sarcopenia. 21.5% met frailty criteria (42% in ≥65 years old patients). <h3>Conclusions</h3> Prevalence of sarcopenia and frailty syndrome in this study was high. Rheumatologists should make an early detection of signs of frailty. The screening and early detection of frailty can spur reforms to make routine care less hazardous, can focus on outcomes most relevant to patients and can aid in understanding effectiveness of health care interventions, including at the population level. <h3>Disclosure of Interest</h3> None declared