{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:30:56Z","timestamp":1792132256895,"version":"4.4.0"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["IK2 CX002351"],"award-info":[{"award-number":["IK2 CX002351"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The cross\u2010sectional association between rheumatoid arthritis (RA) disease activity and frailty has been described; however, the longitudinal relationship is less well understood. We evaluated the association between disease activity and frailty over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We used a longitudinal RA cohort established at the Department of Veterans Affairs Puget Sound Health Care System. RA disease activity (Disease Activity Score in 28 joints using the C\u2010reactive protein level [DAS28\u2010CRP]) and frailty (measured by the Fried Frailty Phenotype [FFP]) were evaluated at baseline and at one year. Frailty was categorized as robust, prefrail, or frail. Ordinal logistic regressions assessed the cross\u2010sectional associations of DAS28\u2010CRP and frailty at baseline and at one year. Paired\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests and multivariable mixed ordinal logistic regressions assessed the longitudinal associations of DAS28\u2010CRP and frailty. Models were adjusted for age, sex, disease duration, prednisone use, conventional synthetic disease\u2010modifying antirheumatic drug (DMARD) use, and biologic DMARD use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 132 patients with RA aged 64.2 \u00b1 11.3 years were included; 73% were male, 69% were White, 11% were Black, and 12% reported multiple races. The mean \u00b1 SD baseline DAS28\u2010CRP was 3.9 \u00b1 1.3, and frailty was categorized as robust in 35 (27%) patients, prefrail in 77 (58%) patients, and frail in 20 (15%) patients. DAS28\u2010CRP (per 1\u2010unit increase) was associated with a higher FFP category at baseline (adjusted odds ratio [aOR] 1.98,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.0001). Disease activity increased in those whose frailty score worsened at one year (mean \u00b1 SD change score 0.61 \u00b1 0.96,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.0121). An increased DAS28\u2010CRP was independently associated with a higher frailty category over one year (aOR 3.31,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.0001; n = 65).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Disease activity is independently associated with phenotypic frailty. Increased disease activity over time is associated with worsening frailty status. Future studies are needed to explore this longitudinal relationship and to determine if controlling disease activity can mitigate frailty.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.25615","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T05:34:26Z","timestamp":1753335266000},"page":"307-315","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Evaluating the Longitudinal Association of Rheumatoid Arthritis Disease Activity With Phenotypic Frailty: Evidence for Secondary Frailty?"],"prefix":"10.1002","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1964-5318","authenticated-orcid":false,"given":"Hannah F.","family":"Brubeck","sequence":"first","affiliation":[{"name":"VA Puget Sound Health Care System  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kylie E.","family":"Riggles","sequence":"additional","affiliation":[{"name":"VA Puget Sound Health Care System  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riley S.","family":"Bass","sequence":"additional","affiliation":[{"name":"VA Puget Sound Health Care System  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth R.","family":"Wahl","sequence":"additional","affiliation":[{"name":"VA Puget Sound Health Care System and University of Washington  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Mount","sequence":"additional","affiliation":[{"name":"VA Puget Sound Health Care System and University of Washington  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dolores M.","family":"Shoback","sequence":"additional","affiliation":[{"name":"San Francisco VA Medical Center and University of California San Francisco  San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James S.","family":"Andrews","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham, Birmingham VA Health Care System, and Atlanta\u2010Birmingham VA Geriatric Research Education and Clinical Center  Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose M.","family":"Garcia","sequence":"additional","affiliation":[{"name":"VA Puget Sound Health Care System, Puget Sound Geriatric Research Education and Clinical Center, and University of Washington  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariela R.","family":"Orkaby","sequence":"additional","affiliation":[{"name":"New England Geriatric Research, Education, and Clinical Center, VA Boston Healthcare System, Brigham and Women's Hospital, and Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua F.","family":"Baker","sequence":"additional","affiliation":[{"name":"Corporal Crescenz VA Medical Center and University of Pennsylvania  Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8146-2519","authenticated-orcid":false,"given":"Patricia P.","family":"Katz","sequence":"additional","affiliation":[{"name":"University of California San Francisco  San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine D.","family":"Wysham","sequence":"additional","affiliation":[{"name":"VA Puget Sound Health Care System, Puget Sound Geriatric Research Education and Clinical Center, and University of Washington  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2754-5233","authenticated-orcid":false,"given":"Courtney N.","family":"Loecker","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical 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