Frailty assessment in patients with systemic sclerosis

Area of Science:

• Rheumatology
• Geriatrics
• Clinical Medicine

Background:

• Frailty is a clinical syndrome of reduced physiological reserve, increasing vulnerability to adverse outcomes.
• Systemic sclerosis (SSc) is a chronic autoimmune disease with significant morbidity.
• The prevalence and impact of frailty in SSc patients over 60 years old are not well understood.

Purpose of the Study:

• To determine the prevalence of frailty in older SSc patients.
• To identify demographic and clinical factors associated with frailty in this population.
• To explore the predictive value of frailty for adverse events like hospitalization and mortality.

Main Methods:

• A cross-sectional study assessed 169 SSc outpatients (age > 60) using the Primary Care Frailty Index (PC-FI).
• Comorbidities, SSc disease activity, organ damage, and patient-reported impact were evaluated using validated indices.
• Hospitalizations and mortality data were collected during follow-up for 85 patients.

Main Results:

• Frailty was prevalent in 51.3% of SSc patients, with varying severity levels.
• Frail patients were older, had longer disease duration, and higher comorbidity and organ damage scores.
• Multivariate analysis revealed disease duration and SSc-related organ damage as independent predictors of frailty scores.

Conclusions:

• Frailty is common in older SSc patients and is associated with SSc-related organ damage and comorbidities.
• The PC-FI shows potential for predicting hospitalization and death in SSc.
• Frailty assessment could be a valuable tool for health program planning in SSc care.