Increased frailty in people with osteoarthritis and rheumatoid arthritis and the influence of co-morbidity: an analysis of the UK Biobank cohort

Research output: Contribution to journalArticlepeer-review


Objectives: To determine the association between osteoarthritis (OA), rheumatoid arthritis (RA) and frailty and to determine whether co-morbidities interact with OA and RA to further increase the likelihood of frailty.
Methods: Participants of the UK Biobank aged 40-69 years at baseline were included. Demographic, lifestyle, and clinical data were collected at baseline, and follow-up in a subset. Frailty was assessed using a frailty index (FI) (continuous) and a modified frailty phenotype (robust, pre-frail, frail). The association between RA and OA and frailty at baseline and follow up, was assessed using multiple regression models. We looked at whether co-morbidities, including cardiovascular disease, diabetes, chronic obstructive pulmonary disease and depression, interacted additively with OA and RA to increase the likelihood of frailty.
Results: 457,561 participants contributed data. Those with (versus without) RA (n=4,894), and OA (n=35,884), respectively were more likely to be frail, adjusted relative risk ratio (95%CI) 10.7 (9.7, 11.7) and 3.4 (3.3, 3.6), and were more likely to have a higher FI at baseline. There was evidence of additive interaction, between RA, OA, and common co-morbidities increasing the occurrence of prevalent frailty. Among 25,163 participants included in longitudinal analysis, people with RA (n=202) and OA (n=1,811), at baseline had an increased adjusted frailty incidence rate ratio, 2.8 (1.7, 4.6) and 1.7 (1.3, 2.1) respectively and also a higher FI during follow up.
Conclusion: People with RA and OA are more likely to have, or develop, frailty. Common comorbidities interact with OA and RA to further increase the likelihood of frailty.

Bibliographical metadata

Original languageEnglish
JournalArthritis Care & Research
Publication statusAccepted/In press - 1 Jun 2021

Related information