SLICC-Frailty Index is independently associated with impaired physical function, activities of daily living and quality of life measures

Abstract

OBJECTIVE: The SLICC Frailty Index (SLICC-FI) was developed to assess health deficits including disease activity, organ damage, comorbidities and functional status. We examined any relationship between SLICC-FI and objective physical function measures, activities of daily living performance and quality of life in SLE. METHODS: SLICC-FI was estimated using data from patient files and patient-reported questionnaires. Jamar Dynamometer, pinch gauge and Purdue pegboard test measured grip strength, pinch strength and dexterity, respectively. Activities of daily living performance was assessed by the Disabilities of Arm, Shoulder and Hand (DASH) questionnaire and HAQ. Quality of life was evaluated by LupusQol questionnaire. RESULTS: This cross-sectional study included 240 SLE patients (90% female, mean (s.d.) age: 47.63 (13.01), median (IQR) disease duration: 9 (4-16)). Mean (s.d.) SLICC-FI was 0.09 (0.06). Forty-three (17.9%) patients were classified as robust, 105 (43.8%) as relatively less fit, 77 (32.1%) as least fit and 15 (6.2%) as frail. In univariate analysis, SLICC-FI was significantly associated with DASH and HAQ with an inverse association with grip strength, pinch strength and all purdue scores (all P < 0.001). A negative correlation was found between SLICC-FI score and all LupusQoL domain scores (all P < 0.001). All associations remained statistically significant in multivariate regression analysis, after adjustment for age, disease duration, SLEDAI-2K, SLICC, immunosuppressives, corticosteroids and Charlson score. CONCLUSION: SLICC-FI is independently associated with poor physical function and activities of daily living performance and impaired quality of life and may help to identify patients in need of additional interventions beyond routine care.

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