Older patients with rheumatic disease report low levels of ‘vigorous’ physical activity
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Older patients with rheumatic diseases are less to report “vigorous” levels of physical activity, compared with other age groups, which may lead to more lifestyle difficulties, according to data published in The Journal of Rheumatology.
“Physical activity (PA) offers primary, secondary and tertiary prevention of several chronic conditions like hypertension, obesity and cardiovascular disease,” Anand Kumthekar, MD, of the Albert Einstein College of Medicine, in New York, and colleagues wrote. “In order to understand how to intervene on physical activity amongst older patients with rheumatic diseases, it is paramount to first define and describe the problem.”
To examine physical activity among patients with rheumatic diseases, and its correlation with various patient-reported outcomes, Kumthekar and colleagues conducted a cross-sectional study of data from the FORWARD database. The researchers included patients aged 65 years or older with rheumatoid arthritis, spondylarthritis, osteoarthritis, systemic lupus erythematosus or fibromyalgia, and who completed a specific database survey from 2019 regarding physical activity.
For the purposes of this analysis, the researchers used the patient-reported outcomes HAQ-DI and Patient-Reported Outcomes Measurement Information System (PROMIS-29) to measure health domains. The exposure point of interest was the level of patient-reported physical activity.
The analysis included a total of 3,343 patients, among whom 68% had RA. In all, just 14% of the included patients reported engaging in “vigorous” physical activity — defined as at least 30 minutes, three times per week — while 54% reported “moderate” physical activity, according to the researchers. Patients with obesity were “significantly” more likely to report low levels of physical activity.
Meanwhile, patients reporting lower activity scores appeared to have more pain, worse health-related quality of life scores, higher rates of depression and worse scores relating to pain, sleep and fatigue.
“Despite multiple recommendations regarding PA from national and rheumatology specific
organizations, the level of PA is overall quite low in older adults with rheumatic diseases in the U.S.,” Kumthekar and colleagues wrote. “The lower level of PA was associated with greater pain, fatigue and sleep disturbances. Additional efforts are needed to encourage rheumatology providers to council patients on the importance for physical activity.”
Perspective
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Physical activity is a huge component in everyday life and one of the biggest factors we face with some patients with and without rheumatic disease. A challenge we face daily is motivating patients to get up and be active when they don’t feel good, regardless of the circumstances causing their inactivity, including age, weight, physical mobility, fatigue, depression, etc.
The different levels of activity and the results from the patient-reported outcomes in this study are something we see daily. The results of this study can help to refocus our attention to the areas where physical activity is less than desirable with the patients who must endure living with their disease processes daily.
We all would like to be the healthiest, most productive, most energetic and active versions of ourselves that we can be, at any age, under any circumstance. However, for our patients, it doesn’t always happen as we would like due to life in general, disease processes, physical limitations, and many other variables.
Considering the barriers my patients may have, I try to think of any alternative I can to get them physically active and moving. Some of the activities I have my patients perform, both during their infusion and at home, include stretching out a tourniquet, leg lifts in the chair and arm reaches. Most importantly, I also help them understand that any activity is better than nothing. They just need to start somewhere and build on what they can do to keep, and maintain, the function they possess.
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