title: Factors associated with the severity and progression of self-reported hand pain and functional difficulty in community-dwelling older adults: a systematic review.
abstract: BACKGROUND
  Hand problems are common in older adults and cause significant pain and disruption to everyday living. The aim of this systematic review was to summarize evidence on the factors associated with the severity and progression of self-reported hand pain and functional difficulty in population-based studies of older adults.
  
  
  METHODS
  MEDLINE, EMBASE, CINAL, BNI, AMED, HMIC, PsycINFO and ISI Web of Knowledge were searched up to January 2011 for relevant articles. The search strategy combined text words for hand, pain, function and epidemiological study. Inclusion criteria were applied and articles in the review assessed for quality using the QUality In Prognosis Studies (QUIPS) assessment tool. Data extraction included: author, year of publication, study location, participant inclusion criteria, risk factor and outcome measurement, and association with hand pain and/or function.
  
  
  RESULTS
  Seven articles from five studies met the inclusion criteria from 5,679 citations. All studies were cross-sectional and provided no information on progression of hand pain and function over time. Factors associated with limited hand function were older age, female gender, manual occupation, neck or shoulder pain, clinical and radiographic osteoarthritis, weaker hand strength, hand pain, history of Parkinson's disease, stroke, diabetes or rheumatoid arthritis, and illness perceptions (namely, frustration, impact and symptom count). Key factors associated with hand pain severity were age, impact, frustration, patient expectation of a long disease time course and self-reported diagnosis of the cause of the hand problem.
  
  
  CONCLUSIONS
  Both demographic and clinical factors were found to be related to self-reported hand pain severity and functional difficulty in older adults; however, the results were derived from a small number of studies, with no information on progression of hand pain and functional difficulty over time.
authors.affiliation: Arthritis Research UK Primary Care Centre, Keele University, Keele, UK. e.nicholls@cphc.keele.ac.uk
authors.forename: Elaine E
authors.initials: EE
authors.lastname: Nicholls
authors.forename: Danielle A W M
authors.initials: DA
authors.lastname: van der Windt
authors.forename: Joanne L
authors.initials: JL
authors.lastname: Jordan
authors.forename: Krysia S
authors.initials: KS
authors.lastname: Dziedzic
authors.forename: Elaine
authors.initials: E
authors.lastname: Thomas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000453:epidemiology*; D005260:Female; D006225:Hand; D050823:Hand Joints; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000453:epidemiology*