All participants were asked to complete a questionnaire on their activities of daily living, including questions about the ability to feed oneself, dress, use the toilet, bath, walk and do housekeeping without assistance. Difficulty with one or more of these activities was defined as functional disability.
The study found a significantly higher prevalence of functional disability in patients with RA than in those without (26% vs. 11%; P<0.001), with persistent excess in prevalence over time. In addition, the study found this excess prevalence predated the onset of RA by one to two years, suggesting that functional disability begins early in the course of disease and may begin even prior to diagnosis.
The study also found the burden of functional disability affected most groups of patients with RA more than people without RA, with a 15% or more excess in functional disability in RA patients at any age younger than 80 years old. After age 80, functional disability was similar to that of the non-RA group. Researchers also found a higher prevalence of functional disability in both men and women and an increased prevalence of functional disability over disease duration in patients with RF/CCP positivity than those without RF/CCP positivity. Similar results were seen in RA patients who reported difficulty with two or more activities of daily living.
“The implications of this persistent burden of functional disability in RA are broad, including substantial financial and societal burden associated with work disability, extensive use of healthcare resources and suboptimal quality of life,” says Dr. Myasoedova.
Thus, she urged clinicians to keep in mind that functional disability remains a substantial burden for RA patients, despite improved control of disease activity.
“Functional disability is a patient-reported outcome that defines a patient’s quality of life and wellbeing,” she says. “Earlier RA disease recognition with the 2010 ACR/EULAR criteria, timely evaluation and management of physical impairments in the context of morbidity, pain and disease activity in patients with RA can be expected to improve their disability profile.”
Mary Beth Nierengarten is a freelance medical journalist based in Minneapolis.
Reference
- Myasoedova E, Davis JM III, Achenbach SJ, et al. Trends in prevalence of functional disability in rheumatoid arthritis compared with the general population. Mayo Clin Proc. 2019 Jun;94(6):1035–1039.
