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Self-report Functioning According to the ICF Model in Elderly Patients with Rheumatoid Arthritis and in Population Controls Using the Multidimensional Health Assessment Questionnaire ARJA HÄKKINEN, MARJA ARKELA-KAUTIAINEN, TUULIKKI SOKKA, PEKKA HANNONEN, and HANNU KAUTIAINEN
ABSTRACT. 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. Conclusion. 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. (J Rheumatol First Release Dec 1 2008; doi:10.3899/jrheum.080027) Key Indexing Terms:
FUNCTIONING
From the Department of Physical Medicine and Rehabilitation, and Department of Medicine, Central Hospital, Jyväskylä; Department of Health Sciences, University of Jyväskylä, Jyväskylä; and the Rheumatism Foundation Hospital, Heinola, Finland. Supported by the Medical Research Foundation of Jyväskylä Central Hospital. A. Häkkinen, MD, Department of Physical Medicine and Rehabilitation, and Department of Medicine, Central Hospital, Jyväskylä; Department of Health Sciences, University of Jyväskylä; M. Arkela-Kautiainen, MD, Department of Physical Medicine and Rehabilitation, Central Hospital, Jyväskylä; T. Sokka, MD; P. Hannonen, MD, Department of Medicine, Central Hospital, Jyväskylä; H. Kautiainen, MD, Rheumatism Foundation Hospital, Heinola. Address reprint requests to Dr. A. Häkkinen, Department of Physical Medicine and Rehabilitation, Jyväskylä Central Hospital, 40620 Jyväskylä, Finland. E-mail: arja.hakkinen@ksshp.fi Accepted for publication September 26, 2008.
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