Higher Health Assessment Questionnaire Disability Index Research Articles

Procollagen Type I and III Aminoterminal Propeptide Levels and Severity of Interstitial Lung Disease in Mexican Women With Progressive Systemic Sclerosis

BackgroundInterstitial lung disease (ILD) is a frequent complication in progressive systemic sclerosis (SSc), being present in 25% to 90% of cases. ObjectivesTo evaluate whether serum levels of procollagen type I and III aminoterminal propeptide (PINP and PIIINP) correlate with severity and patterns of ILD in Mexican women with SSc. MethodsThirty-three SSc patients were assessed for disease characteristics and anti-topoisomerase antibodies (topo I), and also underwent pulmonary function tests and high-resolution computed tomography (HRCT). Nineteen patients had ILD+SSc, and 14 had no lung involvement (no ILD-SSc); data were compared with those from 45 healthy controls. PINP and PIIINP were assessed in all 3 groups. ResultsPatients with SSc had higher PINP and PIIINP vs controls (P=.001, P<.001, respectively). Compared to no ILD-SSc patients, those with ILD+SSc had longer disease duration in years (P=.005), higher modified Rodnan skin score (P<.001), higher Health Assessment Questionnaire-Disability Index scores (P<.001), higher topo I U/mL (P<.001), PINP (49.28±28.63 vs 32.12±18.58μg/L, P=.05), and PIIINP (4.33±1.03 vs 2.67±1.26μg/L, P<.001) levels. ILD severity based on total HRCT correlated with PINP (r=.388, P=.03) and PIIINP (P=.594, P<.001). On adjusted analysis, ILD severity was associated with disease duration (P=.037), PIIINP (P=.038), and topo I (P=.045). ConclusionsPINP and PIIINP are useful markers for severe ILD+SSc, suggesting they could play a role in the follow-up of this complication in SSc.

Does socioeconomic status affect outcomes in early inflammatory arthritis? Data from a canadian multisite suspected rheumatoid arthritis inception cohort.

To assess the effect of socioeconomic status (SES) on outcomes in patients with early inflammatory arthritis, using data from the Canadian Early Arthritis Cohort (CATCH) study. In an incident cohort, 2023 patients were recruited, and allocated to low SES or high SES groups based on education and income. Outcomes at baseline and 12 months were analyzed in relation to SES including the 28-joint Disease Activity Score (DAS28), Simplified Disease Activity Index (SDAI), pain, patient's global assessment scale (PtGA), the Health Assessment Questionnaire-Disability Index (HAQ-DI), and the SF12-v2 Health Survey, using the ANOVA, chi-squared test, and regression analyses. The CATCH population had 43% with high school education or less and 37% in the low-income group (< 50,000 Can$ per annum household income). The low-education group had higher DAS28 at baseline (p = 0.045), becoming nonsignificant at 12 months and lower physical component score on SF12-v2 at baseline (p = 0.022). Patients in the low-income group presented with higher HAQ-DI (p = 0.017), pain (p = 0.035), PtGA (p = 0.004), and SDAI (p = 0.022). Low-income versus high-income groups were associated with an OR above the median for HAQ-DI (1.20; 95% CI 1.00-1.45), PtGA (1.27; 95% CI 1.06-1.53), and SDAI (1.25; 95% CI 1.02-1.52) at baseline. The association with low income persisted at 12 months for HAQ-DI (OR 1.30; 95% CI 1.02-1.67), but not for other variables. Low SES was initially associated with higher disease activity, pain, and PtGA, and poorer function. At 1 year, outcomes were similar to those with high SES, with the exception of HAQ-DI.

Do Patients with Elderly-Onset Rheumatoid Arthritis Have Severe Functional Disability?

To identify the clinical features of elderly-onset rheumatoid arthritis (EORA) and their impact on disease outcome. A total of 3169 rheumatoid arthritis (RA) patients were recruited as part of the Korean Observational Study Network for Arthritis, the nationwide cohort of South Korea. Patients were stratified according to age at disease onset: <40 years (younger age-onset RA, n = 1167), between the ages of 40 and 59 (middle-aged-onset RA, n = 1516), and ≥60 years (EORA, n = 486). To evaluate the significance of differences in clinical features among these 3 groups, we performed analysis of variance (anova) and the χ(2) test. We used multivariable logistic regression analysis to examine the association of onset age with functional disability measured with Health Assessment Questionnaire-Disability Index (HAQDI). EORA patients were associated with high HAQDI (≥1) in bivariable analysis [odds ratio (OR) 1.36, confidence interval (CI) 1.04-1.77]. However, in multivariable analysis, not elderly onset but patients' age, female gender, high disease activity, disease duration over 10 years, and comorbidity with cardiovascular disease were associated with high HAQDI. Only in a predefined subgroup with disease duration <10 years, elderly onset was an independent influencing factor for the functional disability of RA patients (OR 3.04, CI 1.85-5.67: disease duration of <5 years, OR 3.07, CI 1.64-5.74: disease duration of 5 to 10 years). Disease onset in older age was associated independently with functional disability of RA patients who have relatively short disease duration.

Work productivity in scleroderma: Analysis from the University of California, Los Angeles scleroderma quality of life study

To examine the productivity of patients with scleroderma (systemic sclerosis [SSc]) both outside of and within the home in a large observational cohort. One hundred sixty-two patients completed the Work Productivity Survey. Patients indicated whether or not they were employed outside of the home, how many days per month they missed work (employment or household work) due to SSc, and how many days per month productivity was decreased by ≥50%. Patients also completed other patient-reported outcome measures. We developed binomial regression models to assess the predictors of days missed from work (paid employment or household activities). The covariates included: type of SSc, education, physician and patient global assessments, Health Assessment Questionnaire (HAQ) disability index (DI), Functional Assessment of Chronic Illness Therapy-Fatigue, and Center of Epidemiologic Studies Depression Scale Short Form. The mean age of patients was 51.8 years and 52% had limited cutaneous SSc. Of the 37% of patients employed outside of the home, patients reported missing 2.6 days per month of work and had 2.5 days per month of productivity reduced by half. Of the 102 patients who were not employed, 39.4% were unable to work due to their SSc. When we assessed patients for household activities (n = 162), patients missed an average of 8 days of housework per month and had productivity reduced by an average of 6 days per month. In the regression models, patients with lower education and poor assessment of overall health by a physician were more likely to miss work outside of the home. Patients with limited cutaneous SSc and high HAQ DI scores were more likely to miss work at home. SSc has a major impact on productivity at home and at work. Nearly 40% of patients reported disability due to their SSc.

Impact of musculoskeletal pain on physical function and health-related quality of life in a rural community in south India: A WHO-ILAR-COPCORD-BJD India Study

Musculoskeletal (MSK) pain poses a major burden on individuals and health care systems. Assessing its pervasive impact has broadened the horizon of treatment strategies. The aim of this study was to determine the prevalence of MSK pain and its relationship with the health-related quality of life (HRQL) in a rural community. Individuals (>15years) with MSK pain were identified by house-house survey from a population of 6,763 individuals. HRQL was assessed using the validated 'Modified Indian HAQ (CRD - Pune)', translated into regional language. Moderate and severe health assessment questionnaire disability index (HAQ-DI) scores were considered significant. Details regarding the impact of pain on their personal, family and social life were also studied. All individuals with MSK pain were evaluated clinically by a medical team and HAQ-DI was compared in different groups of disorders. Prevalence of MSK pain in the community (mean age, 52 ± 15.8years) was 26.08% (95% CI 25.03-27.13). About 8% of the respondents reporting MSK pain had to stop work and 4% had chronic depression. A significant HAQ-DI was scored by 31% subjects. Level of education and intensity of work had significant associations with HRQL. Among the clinical diagnoses, non-specific MSK pain also scored a high HAQ-DI. MSK pain, both due to specific and non-specific disorders, showed an important impact on HRQL in this community study. Combined with ascertainment of risk factors and associations, this has implications on planning treatment and prevention. We plan to continue using HAQ in time to monitor the community.