Comparison of work disability and health-related quality of life between males and females with rheumatoid arthritis below the age of 45 years.
OBJECTIVE
To compare work disability (WD) and health status between males and females with rheumatoid arthritis (RA) in the age group 18-45 years, and to compare health status between patients with and without WD within each gender, and finally to identify factors independently associated with WD in this age group.


METHODS
A cross-sectional study of RA patients at the time starting with disease-modifying antirheumatic drug (DMARD) therapy and/or biological treatment. Patients receiving a permanent, national WD pension corresponding to >or= 50% were defined as work disabled. We examined gender differences with regard to disease characteristics, health status and WD. The Mann-Whitney U-test and Pearson's chi(2)-test were applied for group comparisons. Multiple logistic regression analyses with adjustments for duration of education, disease duration, age, erosive disease, disability score [using the Modified Health Assessment Questionnaire (MHAQ)], Disease Activity Score-28 (DAS-28), the Short Form Health Survey (SF-36) mental health score and gender were used to identify variables associated with WD.


RESULTS
Out of 474 (372 females) patients, the number (%) of work-disabled females/males was 91 (24.7)/8 (8.1) (p<0.001). WD was associated with worse health status in both genders. The odds ratio (95% confidence interval) [OR (95% CI)] for WD in females vs. males was 4.84 (1.85-12.65) in the multivariate analyses. Other factors independently associated with WD were worse mental health, disease duration and low level of education.


CONCLUSIONS
Females with RA had a fourfold increased risk of WD compared to men. Low level of education, disease duration and worse mental health were also independently associated with WD.
Wallenius
M
M
Department of Rheumatology, Trondheim University Hospital, Trondheim, Norway. marianne.wallenius@ntnu.no
Skomsvoll
J F
JF
Koldingsnes
W
W
Rødevand
E
E
Mikkelsen
K
K
Kaufmann
C
C
Kvien
T K
TK
D000293:Adolescent; D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000453:epidemiology* / Q000532:radiotherapy; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012307:Risk Factors; D012727:Sex Characteristics; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D055815:Young Adult
D018501:Antirheumatic Agents