title: Disability impact on quality of life in Mexican adults with juvenile idiopathic arthritis and juvenile ankylosing spondylitis.
abstract: OBJECTIVE
  Our aim was to determine the disability impact on quality of life (QOL) in Mexican adults with juvenile idiopathic arthritis polyarticular course (JIAPA) and juvenile ankylosing spondylitis (JAS).
  
  
  METHODS
  A cross-sectional study was performed on 32 adult patients with juvenile idiopathic arthritis. Functional outcome was evaluated using Global Functional Status (GFS) according to American College of Rheumatology (ACR) and Spanish Health Assessment Questionnaire-Disability Index (HAQ-DI) arthritis-specific measurements for functional disability in patients with polyarticular course and Bath Ankylosing Spondylitis Functional Index (BASFI) for those who developed JAS. Quality of life (QOL) was assessed using SF-36 and EuroQol 5D (EQ-5D). Descriptive statistics and associations among clinical, functional, and QOL measurements were examined using Spearman's correlation test. Multiple regression analysis was used to estimate predictor factors for impaired QOL. Differences between groups were evaluated by Fisher exact and Mann-Whitney U tests, and p values of <0.05 were considered statistically significant.
  
  
  RESULTS
  JIAPA and JAS had GFS III/IV in 65 and 50%, respectively. A HAQ-DI score of > 1.5 was found in 35% of JIAPA, and a BASFI score of > 5 in 92% of JAS. Patients with JIAPA and JAS reported lower scores for all physical domains and for mental domains (physical role, social functioning, and emotional role) compared with Mexican population scores (p < 0.005). Health status between both groups studied does not show significant differences (p > 0.05). EQ-5D showed impairment in all five dimensions for both groups studied. Multiple regression analysis showed that GFS was the only variable that affects QOL assessed by SF36.
  
  
  CONCLUSIONS
  In our study population, JIAPA and JAS exhibited a great disability impact on QOL and poor functional outcome during the patients' adult life. GFS has a significant impact on quality of life.
authors.affiliation: Department of Rheumatology, Instituto Nacional de Rehabilitación, Mexico City. caro20@ prodigy.net.mx
authors.forename: C
authors.initials: C
authors.lastname: Duarte-Salazar
authors.forename: S
authors.initials: S
authors.lastname: Guzmán-Vázquez
authors.forename: H
authors.initials: H
authors.lastname: Soto-Molina
authors.forename: P
authors.initials: P
authors.lastname: Cháidez-Rosales
authors.forename: V
authors.initials: V
authors.lastname: Ilizaliturri-Sánchez
authors.forename: J
authors.initials: J
authors.lastname: Nieves-Silva
authors.forename: F
authors.initials: F
authors.lastname: Valero-González
authors.forename: J M
authors.initials: JM
authors.lastname: Aguilera-Zepeda
mesh_terms: D000328:Adult; D001171:Arthritis, Juvenile / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008800:Mexico; D011788:Quality of Life; D013167:Spondylitis, Ankylosing / Q000503:physiopathology*