Frailty Measures in SLE Show Variable Agreement and Predictive Value

Investigators found that evaluating frailty in systemic lupus erythematosus (SLE) with different frailty measures can yield variable classifications, but are generally predictive of adverse health outcomes.

The analysis, using data from the California Lupus Epidemiology Study, compared four frailty measures: the Systemic Lupus International Collaborating Clinics Frailty Index (SLICC-FI), the Short Physical Performance Battery (SPPB), the FRAIL scale, and the Patient-Reported Outcomes Measurement Information System Physical Function 10a (PF). The percentage of patients classified as frail varied widely, from 10.8% to 45.9%, and agreement between measures ranged from slight to substantial (kappa 0.17 to 0.63). 

“Multiple measures of frailty appear to identify the risk of poor health outcomes,” the authors reported. Most measures correlated with both cross-sectional and longitudinal health outcomes, including hospitalization risk, disability, disease damage progression, cognitive impairment, fatigue, and depression.

However, the SPPB did not consistently predict these outcomes. “SLICC-FI had the most consistent association with outcomes, followed by FRAIL and PF,” the study noted. 

Given these findings, the researchers emphasized that the choice of frailty measure should depend on its intended use and ease of implementation in clinical practice. “The intended use, as well as the simplicity and practicality of implementing the measure, may be the most important considerations in choosing a frailty measure,” they concluded.

Reference
Katz P, Dall'Era M, Plantinga L, Barbour KE, Greenlund KJ, Yazdany J. Measuring frailty in systemic lupus erythematosus. Arthritis Care Res (Hoboken). Published online December 8, 2024. doi:10.1002/acr.25479