title: Self-report functioning according to the ICF model in elderly patients with rheumatoid arthritis and in population controls using the multidimensional health assessment questionnaire.
abstract: OBJECTIVE
  To assess disability and functioning of elderly patients with rheumatoid arthritis (RA) and population controls by linking the items included in the self-report Multidimensional Health Assessment Questionnaire (MDHAQ) with components of the WHO International Classification of Functioning, Disability and Health (ICF) instrument.
  
  
  METHODS
  In total, 1439 patients with RA (mean age 66 yrs, men 29%) and 957 population controls (65 yrs, men 27%) completed a mailed questionnaire. Functioning was recorded by the Finnish version of MDHAQ. Data included comorbidity, subjective health, education level, employment, exercise habits, self-report joint pain/tenderness, and, for patients, the disease duration.
  
  
  RESULTS
  Patients had lower levels of functioning compared to controls in all ICF domains, with the exception that male patients functioned comparably to male controls in the "general tasks and demands" domain. In patients, disease activity, education, exercise frequency, and comorbidities were expectedly associated with lower functioning in the body structure and function component, while male sex and subjectively perceived health were associated with more favorable functioning. In the activity and participation components, disease activity, exercise frequency, and comorbidities were associated with impaired functioning, while better health on self-report was associated with better functioning.
  
  
  CONCLUSIONS
  There is an extra burden of disability in elderly patients with RA compared to the reference population. With a large patient and control population sample, our study shows that use of the self-report MDHAQ identifies all 3 main components of the ICF framework, thus covering a wide spectrum of functioning. Elderly patients with RA, in comparison to population controls, encounter more difficulties in daily activities and their social life.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Jyväskylä Central Hospital, 40620 Jyväskylä, Finland. arja.hakkinen@ksshp.fi
authors.forename: Arja
authors.initials: A
authors.lastname: Häkkinen
authors.forename: Marja
authors.initials: M
authors.lastname: Arkela-Kautiainen
authors.forename: Tuulikki
authors.initials: T
authors.lastname: Sokka
authors.forename: Pekka
authors.initials: P
authors.lastname: Hannonen
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged; D018771:Arthralgia / Q000175:diagnosis / Q000453:epidemiology; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D001294:Attitude to Health; D015897:Comorbidity; D017281:Cost of Illness; D004185:Disability Evaluation; D004522:Educational Status; D005081:Exercise Therapy / Q000706:statistics & numerical data; D005260:Female; D005387:Finland / Q000453:epidemiology; D014943:Global Health; D006304:Health Status; D006801:Humans; D055809:Illness Behavior; D008297:Male; D008875:Middle Aged; D012647:Self-Assessment; D017678:Sex Distribution; D011795:Surveys and Questionnaires