TOPLINE:

Older adults with rheumatoid arthritis (RA) had a higher prevalence of frailty than control individuals from the general population, which was linked to disease-related consequences such as fatigue, comorbidities, and functional limitations rather than age.

METHODOLOGY:

• Researchers used cross-sectional data from the STAR study to compare the prevalence of frailty and its drivers between older adults with RA and control individuals from the general population.
• They included 207 patients with RA (mean age, 68 years; 62% women) and 214 control individuals (mean age, 68 years; 60% women) recruited from two hospitals in Netherlands between December 2022 and April 2025.
• Frailty was assessed using the self-reported Groningen Frailty Indicator (GFI), which evaluated physical, cognitive, social, and psychological domains; a score of 4 or higher indicated frailty.
• A subgroup of 184 participants (88 patients with RA and 96 control individuals) underwent clinical assessment using the Fried criteria, which evaluated five components. Participants meeting one or two criteria were classified as prefrail and those meeting three or more criteria were classified as frail.

TAKEAWAY:

• A higher proportion of patients with RA vs control individuals were classified as frail using the GFI (34% vs 18%; P < .01). In the clinically assessed subgroup, the Fried criteria classified more patients with RA as prefrail (65% vs 45%) or frail (7% vs 5%; P < .05 for both combined).
• Most patients (88%) classified as frail using the GFI were also classified as frail or prefrail using the Fried criteria, but only 36% of those classified as frail or prefrail using the Fried criteria were identified as frail using the GFI.
• Age was not associated with frailty or prefrailty by either instrument in patients with RA or control individuals. RA was not independently associated with GFI-defined frailty after adjusting for multiple factors.
• GFI-defined frailty was associated with living alone, having at least one comorbidity, higher fatigue scores, and anxiety. Fried criteria-defined frailty or prefrailty was linked to higher BMI and worse physical function (P < .05 for all).

IN PRACTICE:

"[The study] suggests that higher frailty prevalence in RA may largely reflect the overlap between frailty determinants and disease-related consequences of RA, rather than representing a distinct geriatric syndrome," the authors wrote.

SOURCE:

The study was led by Saskia P.M. Truijen, Maastricht University Medical Centre+, Maastricht, Netherlands. It was published online on June 17, 2026, in Rheumatology.

LIMITATIONS:

The cross-sectional design prevented establishing cause-effect relationships and limited the assessment of age-related frailty progression. Relatively healthier patients with RA may have been more inclined to participate, possibly introducing selection bias. Control individuals were recruited using convenience methods such as flyers and snowball sampling, which may have limited generalisability.

DISCLOSURES:

The study received support from Pfizer and the Dutch Arthritis Society (ReumaNederland). Several authors reported receiving research grants and consultancy fees from various pharmaceutical companies, and one of them reported being a member of the executive committee of the Assessment of Spondyloarthritis International Society and of the EULAR Quality of Care Committee.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.