Skip to main content
Top
Published in: Health and Quality of Life Outcomes 1/2004

Open Access 01-12-2004 | Research

Health-related quality of life among older adults with arthritis

Authors: Kelli L Dominick, Frank M Ahern, Carol H Gold, Debra A Heller

Published in: Health and Quality of Life Outcomes | Issue 1/2004

Login to get access

Abstract

Background

Health-related quality of life (HRQOL) is a key outcome in arthritis, but few population-based studies have examined the relationship of specific arthritic conditions, such as osteoarthritis (OA) and rheumatoid arthritis (RA) with HRQOL.

Methods

Older adults in Pennsylvania completed a mail version of the Centers for Disease Control and Prevention (CDC) HRQOL modules. Medicare data were used to identify subjects with OA, RA, and no arthritis diagnosis. We compared HRQOL responses among these groups, and we also examined relationships of demographic characteristics to HRQOL among subjects with arthritis.

Results

In analyses controlling for demographic characteristics and comorbidity, subjects with OA and RA had poorer scores than those without arthritis on all HRQOL items, including general health, physical health, mental health, activity limitation, pain, sleep, and feeling healthy and full of energy. HRQOL scores were also lower for those with RA compared to OA. Among individuals with arthritis, all subject characteristics (including age, race, sex, nursing home residence, marital status, income, and comorbid illnesses) were significantly related to at least one HRQOL item. Older age, nursing home residence, and greater comorbidity were the most consistently associated with poorer HRQOL.

Conclusions

Results of this study show that both OA and RA have a significant impact on multiple dimensions of HRQOL among older adults. Results also suggest the CDC HRQOL items are suitable for use among older adults and in mail surveys. Due to the rising number of older adults in many countries, the public health burden of arthritis is expected to increase dramatically. Efforts are needed to enhance access to medical care and disseminate self-management interventions for arthritis.
Appendix
Available only for authorised users
Literature
1.
go back to reference Helmick CG, Lawrence RC, Pollard RA, Lloyd E, Heyse SP: Arthritis and other rheumatic conditions: Who is affected now, Who will be affected later? Arthritis Care and Research 1995, 8: 203–211.PubMedCrossRef Helmick CG, Lawrence RC, Pollard RA, Lloyd E, Heyse SP: Arthritis and other rheumatic conditions: Who is affected now, Who will be affected later? Arthritis Care and Research 1995, 8: 203–211.PubMedCrossRef
2.
go back to reference Centers for Disease Control and Prevention: Prevalence of disabilities and associated health conditions among adults - United States, 1999. Morbidity and Mortality Weekly Report 2001, 50: 120–125. Centers for Disease Control and Prevention: Prevalence of disabilities and associated health conditions among adults - United States, 1999. Morbidity and Mortality Weekly Report 2001, 50: 120–125.
3.
go back to reference Guccione AA, Felson DT, Anderson JJ, Anthony JM, Zhang Y, Wilson PW, Kelly-Yayes M, Wolf PA, Kreger BE, Kannel WB: The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. American Journal of Public Health 1997, 84: 351–358.CrossRef Guccione AA, Felson DT, Anderson JJ, Anthony JM, Zhang Y, Wilson PW, Kelly-Yayes M, Wolf PA, Kreger BE, Kannel WB: The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. American Journal of Public Health 1997, 84: 351–358.CrossRef
4.
go back to reference Dunlop D, Manheim LM, Yelin EH, Song J, Chang RW: The costs of arthritis. Arthritis & Rheumatism 2003, 49: 101–113. 10.1002/art.10913CrossRef Dunlop D, Manheim LM, Yelin EH, Song J, Chang RW: The costs of arthritis. Arthritis & Rheumatism 2003, 49: 101–113. 10.1002/art.10913CrossRef
5.
go back to reference Lawrence RC, Helmick CG, Arnette FC, Deyo RA, Felson DT, Giannini EH, Heyse SP, Hirsch R, Hochberg MC, Hunder GG, Liang MH, Pillemer S, Steen VD, Wolfe F: Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis and Rheumatism 1998, 41: 778–799. 10.1002/1529-0131(199805)41:5<778::AID-ART4>3.0.CO;2-VPubMedCrossRef Lawrence RC, Helmick CG, Arnette FC, Deyo RA, Felson DT, Giannini EH, Heyse SP, Hirsch R, Hochberg MC, Hunder GG, Liang MH, Pillemer S, Steen VD, Wolfe F: Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis and Rheumatism 1998, 41: 778–799. 10.1002/1529-0131(199805)41:5<778::AID-ART4>3.0.CO;2-VPubMedCrossRef
6.
go back to reference March LM, Bachmeier CJM: Economics of OA: a global perspective. Ballieres Clinical Rheumatology 1997, 11: 817–834.PubMedCrossRef March LM, Bachmeier CJM: Economics of OA: a global perspective. Ballieres Clinical Rheumatology 1997, 11: 817–834.PubMedCrossRef
7.
go back to reference Carmona L, Ballina J, Gabriel R, Lafffon A: The burden of musculoskeletal disease in the general population of Spain: results from a national survey. Annals of the Rheumatic Diseases 2001, 60: 1040–1045. 10.1136/ard.60.11.1040PubMedCentralPubMedCrossRef Carmona L, Ballina J, Gabriel R, Lafffon A: The burden of musculoskeletal disease in the general population of Spain: results from a national survey. Annals of the Rheumatic Diseases 2001, 60: 1040–1045. 10.1136/ard.60.11.1040PubMedCentralPubMedCrossRef
8.
go back to reference Badley EM, Wang PP: Arthritis and the aging population: projections of arthritis prevalence in Canada 1991 to 2031. Journal of Rheumatology 1998, 25: 138–144.PubMed Badley EM, Wang PP: Arthritis and the aging population: projections of arthritis prevalence in Canada 1991 to 2031. Journal of Rheumatology 1998, 25: 138–144.PubMed
9.
go back to reference Mili F, Helmick CG, Zack MM: Prevalence of arthritis: analysis of data from the U.S. Behavioral Risk Factor Surveillance System, 1996–1999. Journal of Rheumatology 2002, 29: 1981–1988.PubMed Mili F, Helmick CG, Zack MM: Prevalence of arthritis: analysis of data from the U.S. Behavioral Risk Factor Surveillance System, 1996–1999. Journal of Rheumatology 2002, 29: 1981–1988.PubMed
10.
go back to reference Centers for Disease Control and Prevention: Public health and aging: projected prevalence of self-reported arthritis or chronic joint symptoms among persons aged >65 years -- United States, 2005–2030. Morbidity and Mortality Weekly Report 2003, 52: 489–491. Centers for Disease Control and Prevention: Public health and aging: projected prevalence of self-reported arthritis or chronic joint symptoms among persons aged >65 years -- United States, 2005–2030. Morbidity and Mortality Weekly Report 2003, 52: 489–491.
11.
go back to reference Elders MJ: The increasing impact of arthritis on public health. Journal of Rheumatology Supplement 2000, 60: 6–8. Elders MJ: The increasing impact of arthritis on public health. Journal of Rheumatology Supplement 2000, 60: 6–8.
12.
go back to reference Centers for Disease Control and Prevention: Arthritis prevalence and activity limitations -- United States, 1990. Morbidity and Mortality Weekly Report 1994, 43: 433–438. Centers for Disease Control and Prevention: Arthritis prevalence and activity limitations -- United States, 1990. Morbidity and Mortality Weekly Report 1994, 43: 433–438.
13.
go back to reference Centers for Disease Control and Prevention: Prevalence of arthritis - United States, 1997. Morbidity and Mortality Weekly Report 2001, 50: 334–336. Centers for Disease Control and Prevention: Prevalence of arthritis - United States, 1997. Morbidity and Mortality Weekly Report 2001, 50: 334–336.
14.
go back to reference Hochberg MC, Kasper J, Williamson JD, Skinner A, Fried LP: The contribution of osteoarthritis to disability: Preliminary data from the Women's Health and Aging Study. Journal of Rheumatology 1995, 22: 16–18. Hochberg MC, Kasper J, Williamson JD, Skinner A, Fried LP: The contribution of osteoarthritis to disability: Preliminary data from the Women's Health and Aging Study. Journal of Rheumatology 1995, 22: 16–18.
15.
go back to reference Verbrugge LM, Lepkowski JM, Konkol LL: Levels of disability among U.S. adults with arthritis. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 1991, 46: 571–583. Verbrugge LM, Lepkowski JM, Konkol LL: Levels of disability among U.S. adults with arthritis. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 1991, 46: 571–583.
16.
go back to reference Hopman-Rock M, Odding E, Hofman A, Kraaimaat FW, Bijlsma JWJ: Physical and psychosocial disability in elderly subjects in relation to pain in the hip and/or knee. Journal of Rheumatology 1996, 23: 1037–1044.PubMed Hopman-Rock M, Odding E, Hofman A, Kraaimaat FW, Bijlsma JWJ: Physical and psychosocial disability in elderly subjects in relation to pain in the hip and/or knee. Journal of Rheumatology 1996, 23: 1037–1044.PubMed
17.
go back to reference Ettinger WH, Davis MA, Neuhaus JM, Mallon KP: Long-term physical functioning in persons with knee osteoarthritis from NHANES I: effects of comorbid medical conditions. Journal of Clinical Epidemiology 1994, 47: 809–815.PubMedCrossRef Ettinger WH, Davis MA, Neuhaus JM, Mallon KP: Long-term physical functioning in persons with knee osteoarthritis from NHANES I: effects of comorbid medical conditions. Journal of Clinical Epidemiology 1994, 47: 809–815.PubMedCrossRef
18.
go back to reference Jordan JM, Luta G, Renner JB, Dragomir A, Hochberg MC, Fryer JG: Ethnic differences in self-reported functional status in the rural south: The Johnston County Osteoarthritis Project. Arthritis Care and Research 1996, 9: 483–491.PubMedCrossRef Jordan JM, Luta G, Renner JB, Dragomir A, Hochberg MC, Fryer JG: Ethnic differences in self-reported functional status in the rural south: The Johnston County Osteoarthritis Project. Arthritis Care and Research 1996, 9: 483–491.PubMedCrossRef
19.
go back to reference Jordan JM, Luta G, Renner JB, Linder GF, Dragomir A, Hochberg MC, Fryer JG: Self-reported functional status in osteoarthritis of the knee in a rural southern community: The role of sociodemographic factors, obesity, and knee pain. Arthritis Care and Research 1996, 9: 273–278.PubMedCrossRef Jordan JM, Luta G, Renner JB, Linder GF, Dragomir A, Hochberg MC, Fryer JG: Self-reported functional status in osteoarthritis of the knee in a rural southern community: The role of sociodemographic factors, obesity, and knee pain. Arthritis Care and Research 1996, 9: 273–278.PubMedCrossRef
20.
go back to reference Centers for Disease Control and Prevention: Health-related quality of life among adults with arthritis - Behavioral Risk Factor Surveillance System, 11 states, 1996–1998. Morbidity and Mortality Weekly Report 2000, 49: 366–369. Centers for Disease Control and Prevention: Health-related quality of life among adults with arthritis - Behavioral Risk Factor Surveillance System, 11 states, 1996–1998. Morbidity and Mortality Weekly Report 2000, 49: 366–369.
21.
go back to reference Hagen KB, Kvien TK, Bjorndal A: Musculoskeletal pain and quality of life in patients with noninflammatory joint pain compared to rheumatoid arthritis: a population survey. Journal of Rheumatology 1997, 24: 1703–1709.PubMed Hagen KB, Kvien TK, Bjorndal A: Musculoskeletal pain and quality of life in patients with noninflammatory joint pain compared to rheumatoid arthritis: a population survey. Journal of Rheumatology 1997, 24: 1703–1709.PubMed
22.
go back to reference Hill CL, Parsons J, Taylor A, Leach G: Health related quality of life in a population sample with arthritis. Journal of Rheumatology 1999, 26: 2029–2035.PubMed Hill CL, Parsons J, Taylor A, Leach G: Health related quality of life in a population sample with arthritis. Journal of Rheumatology 1999, 26: 2029–2035.PubMed
23.
go back to reference Moriarty DG, Zack MM, Kobau R: The Centers for Disease Control and Prevention's Healthy Days Measures - Population tracking of perceived physical and mental health over time. Health and Quality of Life Outcomes 2003., 1: Moriarty DG, Zack MM, Kobau R: The Centers for Disease Control and Prevention's Healthy Days Measures - Population tracking of perceived physical and mental health over time. Health and Quality of Life Outcomes 2003., 1:
24.
go back to reference Mili F, Helmick CG, Zack MM, Moriarty DG: Health related quality of life among adults reporting arthritis: analysis of data from the Behavioral Risk Factor Surveillance System, U.S. 1996–1999. Journal of Rheumatology 2003, 30: 160–166.PubMed Mili F, Helmick CG, Zack MM, Moriarty DG: Health related quality of life among adults reporting arthritis: analysis of data from the Behavioral Risk Factor Surveillance System, U.S. 1996–1999. Journal of Rheumatology 2003, 30: 160–166.PubMed
25.
go back to reference Currey SS, Rao JK, Winfield JB, Callahan LF: Performance of a generic health-related quality of life measure in a clinic population with rheumatic disease. Arthritis & Rheumatism 2003, 49: 658–664. 10.1002/art.11381CrossRef Currey SS, Rao JK, Winfield JB, Callahan LF: Performance of a generic health-related quality of life measure in a clinic population with rheumatic disease. Arthritis & Rheumatism 2003, 49: 658–664. 10.1002/art.11381CrossRef
26.
go back to reference Charlson ME, Pompei P, Ales KL, MacKenzie CR: A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases 1987, 40: 373–383.PubMedCrossRef Charlson ME, Pompei P, Ales KL, MacKenzie CR: A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases 1987, 40: 373–383.PubMedCrossRef
27.
go back to reference Deyo RA, Cherkin DC, Ciol MA: Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. Journal of Clinical Epidemiology 1992., 45: Deyo RA, Cherkin DC, Ciol MA: Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. Journal of Clinical Epidemiology 1992., 45:
28.
go back to reference Ounpuu S, Kreuger P, Vermeulen M, Chambers L: Behavioral risk factor surveillance system's health-related quality of life survey tool in a Canadian city. Canadian Journal of Public Health 1998, 91: 67–72. Ounpuu S, Kreuger P, Vermeulen M, Chambers L: Behavioral risk factor surveillance system's health-related quality of life survey tool in a Canadian city. Canadian Journal of Public Health 1998, 91: 67–72.
29.
go back to reference Andresen E, Fouts B, Romeis J, Brownson C: Performance of health-related quality of life instruments in a spinal cord injured population. Archives of Physical Medicine and Rehabilitation 1999, 80: 877–884.PubMedCrossRef Andresen E, Fouts B, Romeis J, Brownson C: Performance of health-related quality of life instruments in a spinal cord injured population. Archives of Physical Medicine and Rehabilitation 1999, 80: 877–884.PubMedCrossRef
30.
go back to reference Brown DW, Balluz LS, Heath GW, Moriarty DG, Ford ES, Giles WH, Mokdad AH: Associations between recommended levels of physical activity and health-related quality of life: Findings from the 2001 Behavioral Risk Factor Surveillance System (BRFSS) survey. Preventive Medicine 2003, 37: 520–528. 10.1016/S0091-7435(03)00179-8PubMedCrossRef Brown DW, Balluz LS, Heath GW, Moriarty DG, Ford ES, Giles WH, Mokdad AH: Associations between recommended levels of physical activity and health-related quality of life: Findings from the 2001 Behavioral Risk Factor Surveillance System (BRFSS) survey. Preventive Medicine 2003, 37: 520–528. 10.1016/S0091-7435(03)00179-8PubMedCrossRef
31.
go back to reference Kaplan RM, Alcaraz JE, Anderson JP, Weisman M: Quality-adjusted life years lost to arthritis: effects of gender, race, and social class. Arthritis Care and Research 1996, 9: 473–482.PubMedCrossRef Kaplan RM, Alcaraz JE, Anderson JP, Weisman M: Quality-adjusted life years lost to arthritis: effects of gender, race, and social class. Arthritis Care and Research 1996, 9: 473–482.PubMedCrossRef
32.
go back to reference Dickens C, Creed F: The burden of depression in patients with rheumatoid arthritis. Rheumatology 2001, 40: 1327–1330. 10.1093/rheumatology/40.12.1327PubMedCrossRef Dickens C, Creed F: The burden of depression in patients with rheumatoid arthritis. Rheumatology 2001, 40: 1327–1330. 10.1093/rheumatology/40.12.1327PubMedCrossRef
33.
go back to reference Ibrahim SA, Burant CJ, Siminoff LA, Stoller EP, Kwoh CK: Self-assessed global quality of life: A comparison of African-American and white older patients with arthritis. Journal of Clinical Epidemiology 2002, 55: 512–517. 10.1016/S0895-4356(01)00501-7PubMedCrossRef Ibrahim SA, Burant CJ, Siminoff LA, Stoller EP, Kwoh CK: Self-assessed global quality of life: A comparison of African-American and white older patients with arthritis. Journal of Clinical Epidemiology 2002, 55: 512–517. 10.1016/S0895-4356(01)00501-7PubMedCrossRef
34.
go back to reference Fowles JB, Lawthers AG, Weinger JP, Garnick DW, Petrie DS, Palmer RH: Agreement between physicians' office records and Medicare Part B claims data. Health Care Financing Review 1995, 16: 189–199.PubMedCentralPubMed Fowles JB, Lawthers AG, Weinger JP, Garnick DW, Petrie DS, Palmer RH: Agreement between physicians' office records and Medicare Part B claims data. Health Care Financing Review 1995, 16: 189–199.PubMedCentralPubMed
35.
go back to reference Katz JN, Barrett J, Liang MH, Bacon AM, Kaplan H, Kieval RI, Lindsey SM, Roberts WN, Sheff DM, Spencer RT, Weaver AL, Baron JA: Sensitivity and positive predictive value of Medicare Part B physician claims for rheumatologic diagnoses and procedures. Arthritis and Rheumatism 1997, 40: 1594–1600.PubMedCrossRef Katz JN, Barrett J, Liang MH, Bacon AM, Kaplan H, Kieval RI, Lindsey SM, Roberts WN, Sheff DM, Spencer RT, Weaver AL, Baron JA: Sensitivity and positive predictive value of Medicare Part B physician claims for rheumatologic diagnoses and procedures. Arthritis and Rheumatism 1997, 40: 1594–1600.PubMedCrossRef
36.
go back to reference Asch DA, Jedrziewski MK, Christakis NA: Response rates to mail surveys published in medical journals. Journal of Clinical Epidemiology 1997, 50: 1129–1136. 10.1016/S0895-4356(97)00126-1PubMedCrossRef Asch DA, Jedrziewski MK, Christakis NA: Response rates to mail surveys published in medical journals. Journal of Clinical Epidemiology 1997, 50: 1129–1136. 10.1016/S0895-4356(97)00126-1PubMedCrossRef
37.
go back to reference Altman RD, Hochberg MC, Moskowitz RW, Schnitzer TJ: Recommendations for the medical management of osteoarthritis of the hip and knee. Arthritis and Rheumatism 2000, 43: 1905–1915. 10.1002/1529-0131(200009)43:9<1905::AID-ANR1>3.0.CO;2-PCrossRef Altman RD, Hochberg MC, Moskowitz RW, Schnitzer TJ: Recommendations for the medical management of osteoarthritis of the hip and knee. Arthritis and Rheumatism 2000, 43: 1905–1915. 10.1002/1529-0131(200009)43:9<1905::AID-ANR1>3.0.CO;2-PCrossRef
38.
go back to reference Rao JK, Callahan LF, Helmick CG: Characteristics of persons with self-reported arthritis and other rheumatic conditions who do not see a doctor. Journal of Rheumatology 1997, 24: 169–173.PubMed Rao JK, Callahan LF, Helmick CG: Characteristics of persons with self-reported arthritis and other rheumatic conditions who do not see a doctor. Journal of Rheumatology 1997, 24: 169–173.PubMed
39.
go back to reference Mazzuca SA, Brandt KD, Katz BP, Dittus RS, Freund D, Lubitz R, Hawker G, Eckert G: Comparison of general internists, family physicians, and rheumatologists managing patients with symptoms of osteoarthritis of the knee. Arthritis Care and Research 1997., 10: Mazzuca SA, Brandt KD, Katz BP, Dittus RS, Freund D, Lubitz R, Hawker G, Eckert G: Comparison of general internists, family physicians, and rheumatologists managing patients with symptoms of osteoarthritis of the knee. Arthritis Care and Research 1997., 10:
40.
go back to reference Arthritis Foundation Association of State and Territorial Health Officials, Centers for Disease Control and Prevention: National Arthritis Action Plan: a public health strategy. Atlanta, Arthritis Foundation 1999. Arthritis Foundation Association of State and Territorial Health Officials, Centers for Disease Control and Prevention: National Arthritis Action Plan: a public health strategy. Atlanta, Arthritis Foundation 1999.
41.
go back to reference Pahor M, Guralnik JM, Wan JY, Ferrucci L, Pennix BWJH, Lyles A, Ling S, Fried Linda P.: Lower body osteoarticular pain and dose of analgesic medications in older disabled women: The Women's Health and Aging study. American Journal of Public Health 1999, 89: 930–934.PubMedCentralPubMedCrossRef Pahor M, Guralnik JM, Wan JY, Ferrucci L, Pennix BWJH, Lyles A, Ling S, Fried Linda P.: Lower body osteoarticular pain and dose of analgesic medications in older disabled women: The Women's Health and Aging study. American Journal of Public Health 1999, 89: 930–934.PubMedCentralPubMedCrossRef
Metadata
Title
Health-related quality of life among older adults with arthritis
Authors
Kelli L Dominick
Frank M Ahern
Carol H Gold
Debra A Heller
Publication date
01-12-2004
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2004
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-2-5

Other articles of this Issue 1/2004

Health and Quality of Life Outcomes 1/2004 Go to the issue