OA associated with higher disability, worse health status
Osteoarthritis was associated with a higher degree of disability and a worse health status among individuals residing in a low-income, urban community in Mexico, according to findings published in the Journal of Clinical Rheumatology.
However, some participants reported a perceived disability in completing daily activities despite not demonstrating said disability, the researchers found.
“This study is important because it explores the impact of OA in the functioning of adults living in a context of socioeconomic disparity, and the functioning is assessed through a novel 3-D methodology,” Adalberto Loyola-Sánchez, PhD, of the University of Calgary, in Alberta, Canada, told Healio Rheumatology. “It is important to assess functioning from multi-perspective methodologies to better understand the disabling effects of rheumatic diseases.”
To evaluate OA’s effect on health and function within low-income populations, the researchers conducted a cross-sectional, community-based study of 439 adults aged 18 years and older in Pueblo Nuevo, Apodaca, Mexico. From December 2014 to November 2015, the researchers used the Community Oriented Program for Control of Rheumatic Diseases methodology to identify individuals with musculoskeletal disease; two rheumatologists confirmed 83 cases of OA.
The researchers determined the participants’ functional abilities through self-reported assessments of the difficulty involved in completing personal care, work and leisure activities. They also used the modified Stanford Health Assessment Questionnaire-Disability Index and the Timed Up and Go test. The patients’ health status was determined through the EuroQoL 5 Dimensions measure.
According to the researchers, the presence of OA was not significantly associated with difficulty performing personal care, work or leisure activities. However, a confirmed case of OA was significantly associated with worse health status, a higher score on the Stanford Health Assessment Questionnaire-Disability Index and a longer Timed Up and Go completion time.
“In the adult OA population, there is a difference between what people perceive they can do and what people actually do in their lives,” Loyola-Sánchez said. “This difference is highly dependent on the context in which individuals live their lives. For example, in a context of low-income suburban communities in Northern Mexico, conventional assessments of functioning shows that OA negatively impacts on their perception and capacity to function. However, exploring what they do in real life shows that they keep doing it, regardless of what they think or demonstrate they could do in standardized situations.”
According to the researchers, their findings underscore the importance of addressing the “mental dimension” in the management of patients with OA in socioeconomically disadvantaged communities.
“In people with OA, it is important to assess functioning from the hypothetical — commonly done with instruments such as the Health Assessment Questionnaire — experimental — assessing functioning in standardized ‘objective’ conditions — and most importantly, the enacted — knowing what people do or can't do in their real life — dimensions,” Loyola-Sánchez said. “It is important to acknowledge that even if people report that they can or cannot do a certain activity, this does not mean they are doing it or not doing it in real life, and that people's context should always need to be taken into account when considering the effects of a chronic illness such as a rheumatic condition.” – by Jason Laday
Disclosure: The researchers report no relevant financial disclosures.