title: Disease activity affects all domains of quality of life in patients with rheumatoid arthritis and is modified by disease duration.
abstract: OBJECTIVE
  This study was conducted to determine how disease activity affects quality of life (QOL) and its interaction with functional impairments, and disease duration in patients with rheumatoid arthritis (RA).
  
  
  METHODS
  This cross-sectional study enrolled 230 patients with RA from a rheumatology clinic in Taiwan and 227 healthy controls matched according to age, sex, marital status, and education. QOL was measured using the Taiwan version of the short form of the World Health Organisation Quality of Life (WHOQOL-BREF) questionnaire. Activity of RA was assessed by the Disease Activity Score in 28 joints using the erythrocyte sedimentation rate (DAS28). Functional disability was assessed by the Health Assessment Questionnaire (HAQ). Multiple regression analyses were performed to explore independent effects and interactions among DAS28, HAQ, and duration after controlling demographic factors.
  
  
  RESULTS
  A higher HAQ score, longer duration of disease, and higher DAS28 score were independently associated with lower QOL scores. DAS28 score affected most items in all physical, psychological, environment, and social domains after controlling other factors. Besides, patients with longer disease duration showed aggravated scores on many facets of the physical and psychological domains, if their disease activity was elevated.
  
  
  CONCLUSIONS
  Disease activity affects QOL of RA patients in all domains. It also aggravates scores in physical and physiological domains among those with a longer duration.
authors.affiliation: Department of Allergy, Immunology and Rheumatology, Changhua Christian Hospital, Changhua, Taiwan. 129273@cch.org.tw.
authors.forename: Ying-Ming
authors.initials: YM
authors.lastname: Chiu
authors.forename: Mei-Shu
authors.initials: MS
authors.lastname: Lai
authors.forename: Hsiao-Yi
authors.initials: HY
authors.lastname: Lin
authors.forename: Hui-Chu
authors.initials: HC
authors.lastname: Lang
authors.forename: Lukas Jyuhn-Hsiarn
authors.initials: LJ
authors.lastname: Lee
authors.forename: Jung-Der
authors.initials: JD
authors.lastname: Wang
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D001799:Blood Sedimentation; D016022:Case-Control Studies; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013624:Taiwan; D013997:Time Factors