title: Health status of patients with ankylosing spondylitis: a comparison with the general population.
abstract: OBJECTIVE
  To examine the subjective health in patients with ankylosing spondylitis (AS) compared with the general population, and to explore the associations between health status and age, sex of the patients, and educational level in AS.
  
  
  METHODS
  Health status was assessed with a generic instrument (SF-36) in 314 patients with AS and in 2323 people from the general population. Subgroup analyses were performed according to age, sex, and educational level. Standard difference scores (s-scores) were calculated to ensure the clinical meaningfulness of the norm based comparisons.
  
  
  RESULTS
  Both men and women with AS reported significantly impaired health on all scales of the SF-36. Women reported significantly worse health on physical health domains. However, when calculating differences from the general population, numerically larger s-scores were found for men (except for physical role and vitality). The relative impact of AS seems to diminish with increasing age. In AS, better health was significantly associated with higher education across all scales. Deviations from the general population on the non-physical health aspects were especially pronounced in patients with low education.
  
  
  CONCLUSIONS
  All key dimensions of health are affected by AS. The physical aspects seem to be most severely affected, but in the less educated group of patients, the disease impact on the mental health aspects was also considerable. Evaluation and management planning should take the complexity of AS into consideration. The focus on physical function should be maintained, and additional attention should be paid to the mental and social consequences of AS.
authors.affiliation: Section for Health Science, University of Oslo, PO Box 1153, Blindern, 0316, Oslo, Norway. h.s.dagfinrud@medisin.uio.no.
authors.forename: H
authors.initials: H
authors.lastname: Dagfinrud
authors.forename: A M
authors.initials: AM
authors.lastname: Mengshoel
authors.forename: K B
authors.initials: KB
authors.lastname: Hagen
authors.forename: J H
authors.initials: JH
authors.lastname: Loge
authors.forename: T K
authors.initials: TK
authors.lastname: Kvien
mesh_terms: D000328:Adult; D000367:Age Factors; D004522:Educational Status; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012737:Sex Factors; D013167:Spondylitis, Ankylosing / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*