Background Rheumatoid Arthritis (RA) is a chronic and disabling condition which affects activities of daily living and participation. To prevent or delay disability it is important to understand how disease activity relates to disability.
Objectives To analyze the association of disease activity to disability in patients with RA. Specifically, we wanted to examine how sociodemographic characteristics modify this association.
Methods Patients fulfilling the American College of Rheumatology classification criteria and presenting in our dedicated outpatient clinic were included consecutively between 2001 and 2005. Disease activity was measured with the Disease Activity Score (DAS) without (DAS3) and including questions on general health (DAS4). Disability was assessed with the Health Assessment Questionnaire (HAQ-DI). Additionally we collected data on age at diagnosis, education and household size. Associations were analysed with logistic regression models with the HAQ-DI score dichotomized at median as dependent variable.
Results 122 patients were included, 79% were female, mean age was 56 years (SD 13), mean age at first diagnosis was 46 years, mean disease duration was 10 years (SD 10.9). Patients had a mean DAS3 of 3.5 and mean DAS4 of 3.8; mean HAQ-DI was 1.0 (SD =0.7; median 1.0). DAS3 and DAS4 were positively correlated with the HAQ-DI score (r =0.53, 0.56). Adjusted for age at diagnosis, sex, education and household size, the association between DAS3 and HAQ-DI summary score was still significant (OR =2.58, 95% confidence interval CI 1.71 to 3.88). Higher age at diagnosis and living alone were associated with lower risk for disability (OR =0.95 per year, 95% CI 0.92 to 0.99; OR =3.13 for living with others, 95% CI 1.10 to 8.93) while higher education was not (OR =0.75, 95% CI 0.21 to 2.72).
Conclusions Disease activity was positively associated with disability as measured with the HAQ-DI. Higher age at diagnosis and living alone were associated with lower risk for disability. Our findings may allow identifying subpopulations at risk for poorer outcomes and thus improving patient care and outcomes in RA.
Disclosure of Interest None Declared
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