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Health Related Quality of Life in Women with Elderly Onset Rheumatoid Arthritis
TED MIKULS, KENNETH SAAG, LINDSEY CRISWELL, LINDA MERLINO, and JAMES R. CERHAN
ABSTRACT.
Methods. A nested case-control study of elderly onset RA within the Iowa Women's Health Study (IWHS), a prospective cohort established in 1986 of 41,000 women aged 55 to 69 years. A supplemental questionnaire was mailed to 122 RA cases and 1132 frequency matched controls from the cohort. We used unconditional logistic regression and linear regression to examine the association of elderly onset RA with self-reported measures of functional disability and quality of life. Results. Elderly onset RA was associated with a 6-fold risk (OR 6.0, 95% CI 3.6–10.1) of significant functional disability (Health Assessment Questionnaire score ³ 1). Similarly, elderly onset RA was significantly associated with lower physical component scores of the Medical Outcome Study Short Form-12 (37.2 ± 10.9 vs 43.6 ± 11.6; p < 0.001). Conclusion. Among a community based cohort, elderly onset RA was strongly associated with functional disability and reduced quality of life. These associations were independent of other age associated factors including depression, recent fracture, and multiple comorbidities. (J Rheumatol 2003;30:952-7) Key Indexing Terms:
RHEUMATOID ARTHRITIS
From the Section of Rheumatology and Immunology, Department of Medicine, University of Nebraska Medical Center and the Omaha VA Medical Center, Omaha, Nebraska; Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama; Rosalind Russell Medical Research Center for Arthritis, Department of Medicine, University of California, San Francisco, San Francisco, California; College of Public Health, University of Iowa, Iowa City, Iowa; and Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA. Supported by a Clinical Science Grant from the Arthritis Foundation and grant R01 CA39741 from the National Cancer Institute. Dr. Mikuls has been supported by training grants from the American College of Rheumatology and Building Interdisciplinary Research Careers in Women's Health (BIRCWH) and a grant from the Agency for Healthcare Research and Quality (HS10389-01). T.R. Mikuls, MD, MSPH, Assistant Professor, Department of Medicine, University of Nebraska Medical Center; K.G. Saag, MD, MSc, Associate Professor, Department of Medicine, University of Alabama at Birmingham; L.A. Criswell, MD, MPH, Associate Professor, Department of Medicine, University of California; L.A. Merlino, MSc, College of Public Health, University of Iowa; J.R. Cerhan, MD, PhD, Associate Professor, Department of Health Sciences Research, Mayo Clinic. Address reprint requests to Dr. T.R. Mikuls, Section of Rheumatology and Immunology, Department of Medicine, University of Nebraska Medical Center, 983025 Nebraska Medical Center, Omaha, NE 68198-3025. E-mail: tmikuls@unmc.edu Submitted April 11, 2002; revision accepted November 4, 2002. |