In a longitudinal analysis of 428 patients with systemic lupus erythematosus (SLE) from a single center, higher frailty scores were significantly associated with poorer future health-related quality of life (HRQoL) across multiple domains, researchers reported in Arthritis Care & Research.

The investigators measured frailty in a Latin American Mestizo cohort according to the Systemic Lupus International Collaborating Clinics-Frailty Index (SLICC-FI) over an average follow-up of 4.71 years and 2645 clinic visits. They used generalized estimating equations to evaluate the impact of frailty on HRQoL, assessed by the LupusQoL instrument. Multivariable models were implemented to account for factors including age at diagnosis, sex, socioeconomic status, disease activity (SLEDAI-2K), cumulative damage (SLICC/ACR damage index), medication use, and baseline HRQoL scores.

Findings demonstrated that higher SLICC-FI scores predicted worse outcomes in the pain, planning, emotional health, and fatigue domains of the LupusQoL. Patients classified as frail or least fit also experienced greater fatigue and had poorer body image.

This study provides compelling longitudinal evidence that frailty, as identified by the SLICC-FI, is a meaningful prognosticator of HRQoL in SLE. By integration frailty assessment into routine clinical evaluation, clinicians may be able to target interventions to help frailer patients preserve or improve their quality of life.

Reference:

Singh A,  Gamboa-Cárdenas RV, Pimentel-Quiroz V, et al. Systemic lupus international collaborating clinics frailty index (SLICC-FI) predicts worsening health-related quality of life: data from the Almenara lupus cohort. Arthritis Care Res. First published April 4, 2025. https://doi.org/10.1002/acr.25544