Source: Addiction  |  Posted 9 years ago

In elderly patients, the onset of rheumatoid arthritis (RA) is closely associated with self-reported functional disability independent of other conditions often accompanied with age.

Previous studies have focused on hospitalised populations and lacked non-RA control groups. To define the disability risk of RA occurring for elderly patients in a community setting, Ted R. Mikuls, M.D., MSPH, of the University of Nebraska Medical Center, Omaha, United States and colleagues studied a population derived from the Iowa Women's Health Study (IWHS), a 1986 program enrolling over 41,000 women between the ages of 55 and 69 years.

After completing a baseline questionnaire in 1986, IWHS participants were queried on RA occurrence in questionnaires distributed in 1992 and 1997. Potential cases received follow up, and the diagnosing physicians were contacted for further information and medical records.

A 2001 survey including a Stanford Health Assessment Questionnaire (HAQ), a 12-item Medical Outcome Study Short Form survey (SF-12), and the Geriatric Depression Scale (GDS) mailed to IWHS participants produced responses for 98 RA cases and 536 non-RA controls eligible for study inclusion.

One half of RA cases met the criteria for significant functional disability (HAQ score > 1). The researchers found the risk of significant functional disability to be 6 times higher for cases of late onset RA in comparison to controls.

Additionally, SF-12 scores for both the physical and mental components were significantly lower in RA cases than for controls. The SF-12 physical component score showed patterns of association between functional disability and late onset RA similar to the HAQ.

The reported increase in functional disability and decrease in quality of life in association with RA appeared independent of other factors including depression, recent fracture, and comorbidities such as cancer, diabetes, cardiovascular disease, hypertension, lung disease, kidney disease, and stroke.

"These results suggest that future work must focus on effective evaluation and implementation of strategies aimed at reducing the burden of TA associated disability among those with elderly onset disease," the researchers conclude.