Perceptions of ageing among middle-aged and older adults with SLE: a single-centre cross-sectional study.

Objective: Negative self-perceptions of ageing are associated with decreased health-related quality of life (HRQoL) in older adults. We sought to characterise the association of self-perceptions of ageing, both positive and negative, with pain, depression and self-reported disability and frailty status in middle-aged and older adults with SLE.

Methods: We enrolled adults ≥50 years with validated SLE in a single-centre cross-sectional study. Sociodemographic characteristics and disease features were self-reported. Self-perceptions of ageing were assessed using awareness of age-related change (AARC). We assessed patient-reported outcomes, disability and frailty status using the Patient-Reported Outcomes Measurement Information System 29-Item Profile (PROMIS-29), Valued Life Activities and Fatigue, Resistance, Ambulation, Illness, Loss of Weight Scale. Associations between AARC gains (ie, positive self-perception of ageing) and losses (ie, negative self-perception of ageing) and pain interference, depression, disability and frailty status (frail ≥3/5 criteria) were assessed using linear or logistic regression and adjusted for age, race, ethnicity, and SLE disease activity and organ damage.

Results: Participants (n=80) were mostly female (95.0%) with mean age and SLE duration of 63.2 (SD=8.5) years and 23.1 (SD=14.5) years, respectively. Mean PROMIS-29 T-scores for pain interference and depression were 54.6 (SD=10.1) and 49.8 (SD=8.5), respectively; 29.9% were frail. After covariate adjustment, AARC losses, but not gains were significantly associated with pain interference (ß coefficient 0.94, 95% CI 0.33 to 1.54, p<0.01), depression (ß coefficient 0.67, 95% CI 0.04 to 1.30, p=0.04) and frailty (OR 2.09, 95% CI 1.30 to 3.37, p<0.01). After covariate adjustment, both AARC gains (ß coefficient -0.07, 95% CI -0.09 to -0.02, p<0.01) and losses (ß coefficient 0.08, 95% CI 0.03 to 0.12, p<0.01) were statistically significantly associated with disability.

Conclusions: Negative self-perception of ageing was independently associated with decreased HRQoL among middle-aged and older adults with SLE. Addressing negative self-perceptions of ageing may improve HRQoL in this population.