Health-related quality of life among older adults with arthritis.
BACKGROUND
Health-related quality of life (HRQOL) is a key outcome in arthritis, but few population-based studies have examined the relationship of specific arthritic conditions, such as osteoarthritis (OA) and rheumatoid arthritis (RA) with HRQOL.


METHODS
Older adults in Pennsylvania completed a mail version of the Centers for Disease Control and Prevention (CDC) HRQOL modules. Medicare data were used to identify subjects with OA, RA, and no arthritis diagnosis. We compared HRQOL responses among these groups, and we also examined relationships of demographic characteristics to HRQOL among subjects with arthritis.


RESULTS
In analyses controlling for demographic characteristics and comorbidity, subjects with OA and RA had poorer scores than those without arthritis on all HRQOL items, including general health, physical health, mental health, activity limitation, pain, sleep, and feeling healthy and full of energy. HRQOL scores were also lower for those with RA compared to OA. Among individuals with arthritis, all subject characteristics (including age, race, sex, nursing home residence, marital status, income, and comorbid illnesses) were significantly related to at least one HRQOL item. Older age, nursing home residence, and greater comorbidity were the most consistently associated with poorer HRQOL.


CONCLUSIONS
Results of this study show that both OA and RA have a significant impact on multiple dimensions of HRQOL among older adults. Results also suggest the CDC HRQOL items are suitable for use among older adults and in mail surveys. Due to the rising number of older adults in many countries, the public health burden of arthritis is expected to increase dramatically. Efforts are needed to enhance access to medical care and disseminate self-management interventions for arthritis.
Dominick
Kelli L
KL
Department of Health Services Research & Development, Durham Department of Veterans Administration Medical Center, 508 Fulton Street, Durham, NC 27705, USA. domin004@mc.duke.edu
Ahern
Frank M
FM
Gold
Carol H
CH
Heller
Debra A
DA
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D016022:Case-Control Studies; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D016345:Medicare Part B; D010003:Osteoarthritis / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D010414:Pennsylvania; D011594:Psychometrics; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012042:Registries; D012737:Sex Factors; D018434:Sickness Impact Profile; D014481:United States