[Associated factors of different fatigue dimensions in elderly patients with rheumatoid arthritis]

Objective: To investigate the associated factors of different dimensions of fatigue in elderly patients with rheumatoid arthritis (RA). Methods: A cross-sectional analysis was performed in the elderly outpatients with RA (age ≥ 60 years) in the First Affiliated Hospital of Sun Yat-sen University from January 2018 to June 2019. Fatigue was measured by Multidimensional Fatigue Inventory-20 (MFI-20) and 36-item Short Form Health Survey-Vitality (SF-36-VT). Physical fatigue and mental fatigue were subsequently measured by MFI-20 subscales. Results: A total of 104 patients were included. Male-to-female ratio was 1∶3.3. The average age was (68±6) years. The MFI-20 score and SF-36-VT score were 60±14 and 64±20, respectively. The score of physical fatigue measured by MFI-20 was 14±3, and mental fatigue scored 10±4 (P<0.001). Arthralgia, disease activity, disability, insomnia, depression and anxiety were correlated with fatigue assessed by MFI-20 (correlated coefficient: 0.48-0.62). Multivariable regression analysis showed that arthralgia and depression were associated with physical fatigue (Standardized regression coefficients were 0.44 and 0.38, respectively). Insomnia, depression and anxiety were associated factors of mental fatigue (Standardized regression coefficients were 0.20, 0.32 and 0.24, respectively). Conclusions: Elderly patients with RA experiencehigh level of fatigue, mainly presenting as physical fatigue. Arthralgia and depression mainly affect physical fatigue, and arthralgia is a critical factor. Insomnia, depression and anxiety are associated with mental fatigue.

目的： 探讨老年类风湿关节炎（RA）患者疲劳的程度、性质及不同类型疲劳的相关因素。 方法： 选取2018年1月至2019年6月中山大学附属第一医院风湿科门诊的老年RA患者（≥60岁）进行横断面研究。利用多维疲劳量表-20（MFI-20）、生活质量量表-活力（SF-36-VT）、及MFI-20的子量表（躯体疲劳、脑力疲劳）进行评估。 结果： 共纳入104例患者，男女比例1∶3.3，年龄（68±6）岁。MFI-20及SF-36-VT的得分分别为（60±14）分和（64±20）分。MFI-20躯体疲劳得分为（14±3）分，脑力疲劳为（10±4）分（P<0.001）。关节疼痛、疾病活动度、残疾、失眠、抑郁及焦虑与疲劳相关（相关系数0.48~0.62）。多元回归分析显示，关节疼痛和抑郁主要与躯体疲劳相关（标准化回归系数分别为：0.44、0.38），失眠、抑郁及焦虑主要与脑力疲劳相关（标准化回归系数分别为：0.20、0.32、0.24）。 结论： 老年RA患者的疲劳程度较高，以躯体疲劳为主。关节疼痛和抑郁是主要影响躯体疲劳的因素，关节疼痛最突出。同时存在失眠、抑郁、焦虑等脑力疲劳因素。.

Keywords: Aged; Arthritis, rheumatoid; Depression; Fatigue; Pain.