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Related Experiment Video

Updated: Jun 23, 2026

Identifying Frailty Using Point-of-Care Ultrasonography: Image Acquisition and Assessment

Identifying Frailty Using Point-of-Care Ultrasonography: Image Acquisition and Assessment

Published on: July 26, 2024

Frailty Predicts Incident Osteoporotic Fractures in Veterans with Rheumatoid Arthritis.

Katherine D Wysham^1,2,3, Hannah F Brubeck¹, Aaron Baraff¹

¹Veterans Affairs (VA) Puget Sound Healthcare System, Seattle, Washington.

Arthritis Care & Research

|June 22, 2026

Summary

Frailty significantly increases the risk of osteoporotic fractures in rheumatoid arthritis (RA) patients. Early identification of frailty using the VA Frailty Index (VAFI) may improve fracture prevention strategies in this population.

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Published on: July 24, 2013

Area of Science:

Rheumatology
Gerontology
Bone Health

Background:

Rheumatoid arthritis (RA) is linked to higher risks of frailty and osteoporosis.
The specific relationship between frailty and new osteoporotic fractures in RA patients remains understudied.

Purpose of the Study:

To investigate the association between frailty, as measured by the VA Frailty Index (VAFI), and the incidence of osteoporotic fractures in a rheumatoid arthritis cohort.
To identify specific frailty components that contribute most significantly to fracture risk.

Main Methods:

Utilized data from the Veterans Affairs Rheumatoid Arthritis (VARA) Registry (n=2,912).
Assessed frailty using the VA Frailty Index (VAFI) and categorized participants (robust, prefrail, mildly, moderately, severely frail).
Employed multivariable Cox proportional hazard models, adjusting for numerous covariates, to determine the risk of incident osteoporotic fractures.

Main Results:

Higher levels of frailty were significantly associated with a stepwise increase in osteoporotic fracture risk (e.g., severe frailty HR 4.67).
Functional deficits, including failure to thrive, muscular issues, and gait abnormality, were key contributors to this association.
A notable 9% of participants experienced incident osteoporotic fractures during the study period.

Conclusions:

Frailty is a significant independent risk factor for incident osteoporotic fractures in individuals with rheumatoid arthritis.
The VA Frailty Index shows promise for improving osteoporosis screening and treatment strategies in high-risk RA patients.
Further research is needed to compare VAFI's predictive performance against existing fracture prediction models.