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Association Between Rheumatoid Arthritis, Frailty Status, and Mortality in Older Adults with Bladder Cancer.

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Rheumatoid arthritis (RA) increases mortality risk in nonfrail older adults with bladder cancer. However, frailty appears to diminish RA's impact on survival, suggesting frailty's influence may be more dominant.

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Area of Science:

  • Gerontology
  • Oncology
  • Rheumatology

Background:

  • Rheumatoid arthritis (RA) is a chronic condition affecting older adults.
  • Bladder cancer survival can be influenced by comorbidities and patient frailty.
  • Understanding the interplay between RA, frailty, and mortality in bladder cancer is crucial.

Purpose of the Study:

  • To investigate the association between rheumatoid arthritis (RA) and all-cause mortality (ACM) and cancer-specific mortality (CSM) in older adults with bladder cancer.
  • To examine the modifying effect of frailty on the RA-mortality relationship in this population.

Main Methods:

  • A retrospective cohort study using SEER-Medicare data from 2004-2017.
  • Included patients aged 65+ diagnosed with bladder cancer.
  • RA and frailty status identified using administrative algorithms; mortality data from SEER registry.

Main Results:

  • Frailty significantly modified the association between RA and mortality outcomes (Pinteraction < .01).
  • In nonfrail patients, RA was linked to higher CSM (aHR 1.17) and ACM (aHR 1.12).
  • In frail patients, RA was not independently associated with CSM (aHR 0.81) or ACM (aHR 0.93).

Conclusions:

  • Frailty is a significant factor influencing health outcomes in older adults.
  • RA is associated with increased mortality risk in nonfrail older adults with bladder cancer.
  • In frail individuals, the impact of frailty on mortality may overshadow that of RA, aiding in outcome prognostication.