Relationship between frailty and physical activity in patients with systemic lupus erythematosus

• Grant number: 24/08334-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: October 01, 2024
• End date: June 30, 2025
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Simone Appenzeller
• Grantee: Enrico Franco Ribeiro da Silva
• Host Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil

Abstract

Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease with variable presentation, course, and prognosis. Despite advances in diagnosis and treatment, it remains associated with significant morbidity and mortality. Early identification of patients at higher risk of negative outcomes may assist in closer monitoring and aggressive treatment, as well as in identifying patients at lower risk. In this regard, the use of the concept of frailty may aid in risk stratification of patients.Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease with considerable variation in its course and outcomes. Risk stratification using frailty may assist in tailoring the approach to patients, especially in determining a higher risk of adverse outcomes.Frailty is a concept traditionally used in geriatrics that is gaining traction in other disciplines and specialties. It can be defined as a state of increased vulnerability to adverse events, with an impact on the risk of death, hospitalization, and other health outcomes. The method of measurement remains without a defined gold standard. The most commonly used instruments to measure frailty are the Fried frailty phenotype and frailty index.Although traditionally associated with aging, frailty is more prevalent in other conditions regardless of age, associated with the accumulation of damage, such as chronic and inflammatory diseases.In rheumatology, there is considerable interest in this topic, with the recent publication of a frailty index in patients with systemic lupus erythematosus and its association with mortality, hospitalization, and accumulated damage.The objective of this study is to determine the frailty index in a cohort of patients with systemic lupus erythematosus, identify factors associated with its occurrence, and clinical complications.The Systemic Lupus International Collaborating Clinics Frailty Index (SLICC-FI) will be applied using a database of patients who meet the classification criteria for systemic lupus erythematosus by the American College of Rheumatology (1997), seen at the rheumatology outpatient clinic of the Hospital de Clínicas da Unicamp, and through a review of medical records that include questionnaires on physical activity (International Physical Activity Questionnaire) (IPAQ-short version), quality of life (Medical Outcomes Study Short-Form 36 - SF-36), activity scores (SLE Disease Activity Index 2000 - SLEDAI 2K), cumulative damage (SLICC/ACR Damage Index - SDI), and assessment of cognitive deficit (Montreal Cognitive Assessment - MOCA).