A RECENT study has revealed that frailty, more than chronological age, significantly impacts the risk of severe infections in older adults diagnosed with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. The retrospective cohort study, conducted at Mass General Brigham Hospital in the US, examined 234 individuals aged 65 or older to assess how age and frailty affect the risk of end-stage renal disease (ESRD), death, and severe infections within two years of diagnosis.
The findings indicate that individuals aged 75 and older were at a higher risk of developing ESRD or death compared to those aged 65–74. However, frailty was not linked to increased risk of these outcomes in older age groups. In contrast, both frailty and age independently increased the risk of severe infections. Frail individuals aged 65–74 had a severe infection rate of 38.9 cases per 100 person-years, while those aged 75 and older experienced 61.9 cases per 100 person-years.
Notably, while age was a significant predictor of ESRD or death, frailty played a larger role in predicting severe infections. These findings suggest that frailty assessments, a measure of biological age, could provide a more accurate risk profile for managing ANCA-associated vasculitis in older adults, beyond chronological age alone.
The study highlights the need for healthcare providers to consider frailty in treatment decisions, especially for managing the risk of infections in frail, older adults.
Aleksandra Zurowska, EMJ
Reference
Sattui S et al. The effects of age and frailty on the risks of end-stage renal disease, death, and severe infection in older adults with antineutrophil cytoplasmic antibody-associated vasculitis: a retrospective cohort study. Lancet Rheumatol. 2024;DOI:10.1016/S2665-9913(24)00193-0.
