Comprehensive geriatric assessment in older adults with rheumatoid arthritis: A pilot cross-sectional study

Older adults with rheumatoid arthritis (RA) frequently present with multiple comorbidities and geriatric syndromes (GS), complicating disease management and increasing vulnerability. Comprehensive geriatric assessment (CGA) is a multidimensional approach evaluating functional, physical, cognitive and psychosocial domains, providing a holistic framework for patient-centered care.

To assess the utility of CGA in identifying multidomain impairments and healthcare needs in older adults with RA and to explore the relationship between comorbidity burden, GS, disease activity and functional status.

This cross-sectional observational study included 100 patients aged ≥65 years fulfilling ACR/EULAR RA criteria. Sociodemographic and clinical data were collected, including pain, fatigue, mobility, nutrition, continence, sensory function, falls, sleep, comorbidities and medication use. All participants underwent musculoskeletal examination, disease activity assessment, and a comprehensive 60-90-minute CGA.

The mean age was 69.9 ± 3.9 years, and 52% were female. The mean Charlson Comorbidity Index (CCI) was 3.24 ± 1.58 and correlated significantly with disease activity (r = 0.207, p = 0.039). Fatigue, pain and functional disability were highly prevalent. Polypharmacy (≥5 medications) was observed in 67% of patients. Cognitive impairment (67%), depression (64%), urinary incontinence (68%) and sleep disturbance (70%) were common. Frailty status was robust in 10%, pre-frail in 57%, and frail in 33%, with 26% reporting falls. CGA identified significant multidomain deficits.

Older adults with RA exhibit substantial hidden vulnerabilities and high comorbidity burden. Integration of CGA into routine care may improve risk stratification, optimize management, enhance medication safety and reduce functional decline within multidisciplinary care settings.