Frailty and rheumatic diseases: evidence to date and lessons learned.

IF 15 1区医学 Q1 RHEUMATOLOGY Lancet Rheumatology Pub Date : 2024-11-11 DOI:10.1016/S2665-9913(24)00191-7

Sarah B Lieber, Katherine D Wysham, Sebastian E Sattui, Raymond Yung, Devyani Misra

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Abstract

Frailty represents a dynamic multisystem state of reduced physiological reserve that increases vulnerability to adverse health outcomes. Frailty occurs prematurely in adults with immune-mediated rheumatic diseases and is emerging as an important risk factor for adverse outcomes in these conditions. In this Series paper, we present a conceptual overview of frailty and its prevalence among patients with immune-mediated rheumatic diseases. We discuss putative mechanisms of frailty relevant to these diseases, tools for frailty measurement, and potential implications of frailty assessment for clinical care. We also explore the complex inter-relationship between frailty, inflammation, and disease activity in immune-mediated rheumatic diseases. As insight is gained into the epidemiology and mechanisms of frailty among patients with immune-mediated inflammatory rheumatic diseases, the possibility of targeting frailty with an intervention that could complement standard disease-modifying therapies to prevent adverse outcomes and improve health-related quality of life becomes closer to reality.

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虚弱与风湿病：迄今为止的证据与经验教训。

虚弱是一种生理储备减少的动态多系统状态，会增加对不良健康后果的脆弱性。在患有免疫介导的风湿性疾病的成年人中，虚弱过早出现，并逐渐成为这些疾病不良后果的一个重要风险因素。在这篇系列论文中，我们从概念上概述了虚弱及其在免疫介导的风湿性疾病患者中的发病率。我们讨论了与这些疾病相关的虚弱假定机制、虚弱测量工具以及虚弱评估对临床护理的潜在影响。我们还探讨了免疫介导的风湿性疾病中虚弱、炎症和疾病活动之间复杂的相互关系。随着人们对免疫介导的炎症性风湿病患者虚弱的流行病学和发病机制有了更深入的了解，针对虚弱采取干预措施的可能性也越来越接近现实，这种干预措施可以补充标准的疾病调节疗法，从而预防不良后果的发生并改善与健康相关的生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lancet Rheumatology RHEUMATOLOGY-

CiteScore

34.70

自引率

3.10%

发文量

279

期刊介绍： The Lancet Rheumatology, an independent journal, is dedicated to publishing content relevant to rheumatology specialists worldwide. It focuses on studies that advance clinical practice, challenge existing norms, and advocate for changes in health policy. The journal covers clinical research, particularly clinical trials, expert reviews, and thought-provoking commentary on the diagnosis, classification, management, and prevention of rheumatic diseases, including arthritis, musculoskeletal disorders, connective tissue diseases, and immune system disorders. Additionally, it publishes high-quality translational studies supported by robust clinical data, prioritizing those that identify potential new therapeutic targets, advance precision medicine efforts, or directly contribute to future clinical trials. With its strong clinical orientation, The Lancet Rheumatology serves as an independent voice for the rheumatology community, advocating strongly for the enhancement of patients' lives affected by rheumatic diseases worldwide.