title: Correlates and predictors of disability in vulnerable US Hispanics with rheumatoid arthritis.
abstract: OBJECTIVE
  US Hispanics with rheumatoid arthritis experience worse functional outcomes compared to whites. The determinants of disability, however, are not well established in large Hispanic cohorts. In the present report, we identified factors associated with disability in a cross-sectional design, and evaluated their individual contributions to disability over time.
  
  
  METHODS
  Two hundred fifty-one Hispanic subjects from a single center were evaluated. Disease activity, serologies, radiographs, treatments, irreversible articular damage (defined as subluxation, arthrodesis, fusion, or prosthesis), and joint replacement surgeries were recorded. Self-reported disability (Health Assessment Questionnaire disability index), patient pain by a visual analog scale, and depression assessments were collected. Cross-sectional factors associated with disability were identified, and their effects on future disability were evaluated in a subgroup of 114 patients assessed 6 months later.
  
  
  RESULTS
  Six parameters were independently related to disability cross-sectionally: pain was the strongest (P < 0.0001), followed by irreversible articular damage, disease activity, depression, age, and fibromyalgia (P < 0.03 for all). Baseline parameters predicting disability 6 months later included, in decreasing significance, irreversible articular damage (P = 0.004), depression, disease activity, age, and pain (all P < 0.04).
  
  
  CONCLUSIONS
  In cross-sectional analysis, self-reported pain had the strongest relationship with disability; however, factors such as irreversible articular damage, depression, and disease activity were more important in predicting future disability. Most of these factors are amenable to targeted interventions and should be addressed in an effort to improve functional outcomes.
authors.affiliation: Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Los Angeles, California 90509, USA. gkarpouzas@labiomed.org
authors.forename: George A
authors.initials: GA
authors.lastname: Karpouzas
authors.forename: Soha
authors.initials: S
authors.lastname: Dolatabadi
authors.forename: Rosalinda
authors.initials: R
authors.lastname: Moran
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.forename: Perry M
authors.initials: PM
authors.lastname: Nicassio
authors.forename: Michael H
authors.initials: MH
authors.lastname: Weisman
mesh_terms: D000328:Adult; D000367:Age Factors; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000208:ethnology* / Q000523:psychology / Q000601:surgery; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000208:ethnology; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000208:ethnology; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D016014:Linear Models; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010146:Pain / Q000175:diagnosis / Q000208:ethnology; D010147:Pain Measurement; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D035862:Vulnerable Populations / Q000523:psychology / Q000706:statistics & numerical data*