The effect of lung involvement on frailty and cognitive dysfunction in patients with rheumatoid arthritis

Introductıon: Rheumatoid arthritis is a systemic inflammatory disease characterized by synovitis, bone, and cartilage destruction. Interstitial lung disease is a significant complication that can occur during the course of rheumatoid arthritis. Frailty is a health problem characterized by a decrease in physiological reserves and function, leading to increased vulnerability. Therefore, in this study, we aimed to investigate the effects of the presence of interstitial lung disease on frailty and cognitive function in patients with rheumatoid arthritis. Methods: A total of 80 patients, 40 with ILD and 40 without ILD, aged between 30 and 80 years, were included in the study. FRAIL and Edmonton Frailty Scales were administered to assess frailty, and the Mini Mental State Examination was used to evaluate cognitive status in patients. Disease activity was measured using SDAI, DAS28-CRP, and RADAI-5. Additionally, DEXA and vitamin D measurements were recorded to evaluate the relationship between osteoporosis and frailty. HRCT patterns and SFT-DLCO parameters of ILD patients were also utilized for the study. SPSS 25.0 software package was used for data analysis in the study. Resuılts: The ILD group exhibited higher frailty with both the FRAIL (p=0.001) and Edmonton (p=0.004) scales, as well as lower cognitive function assessed by MMSE (p=0.038). Disease activity scores were similar in both groups. No statistically significant results were found regarding frailty and cognitive function concerning DEXA and vitamin D in both groups. UIP pattern was found to be associated with higher frailty (p=0.045). Disease activity scores showed a positive correlation with frailty. A decrease in cognitive function was observed with increasing frailty. Conclusıon: The presence of ILD emerges as an extra-articular manifestation that increases frailty in RA patients. Managing RA and its systemic manifestations is an important tool in preventing frailty and thus disability. Keywords: Rheumatoid arthritis, Interstitial lung disease, Frailty, Cognitive Status