Joëlle van den Hoek1, Leo D Roorda2, Hendriek C Boshuizen2, Gerard J Tijhuis2, Geertrudis A van den Bos2, Joost Dekker2. 1. From the Amsterdam Rehabilitation Research Center | Reade; Department of Social Medicine, Academic Medical Center, University of Amsterdam; Departments of Rehabilitation and Psychiatry, EMGO Institute, Vrije Universiteit (VU) University Medical Center Amsterdam, Amsterdam; National Institute of Public Health and the Environment, Bilthoven; Biometrics, Wageningen University and Research Centre, Wageningen, the Netherlands.J. van den Hoek, MSc, Amsterdam Rehabilitation Research Center | Reade, and Department of Social Medicine, Academic Medical Center, University of Amsterdam; L.D. Roorda, MD, PT, PhD, Amsterdam Rehabilitation Research Center | Reade; H.C. Boshuizen, PhD, National Institute of Public Health and the Environment, and Biometrics, Wageningen University and Research Centre; G.J. Tijhuis, MD, PhD, Amsterdam Rehabilitation Research Center | Reade; G.A. van den Bos, PhD, Department of Social Medicine, Academic Medical Center, University of Amsterdam; J. Dekker, PhD, Amsterdam Rehabilitation Research Center | Reade, and Departments of Rehabilitation and Psychiatry, EMGO Institute, VU University Medical Center Amsterdam. j.vd.hoek@reade.nl. 2. From the Amsterdam Rehabilitation Research Center | Reade; Department of Social Medicine, Academic Medical Center, University of Amsterdam; Departments of Rehabilitation and Psychiatry, EMGO Institute, Vrije Universiteit (VU) University Medical Center Amsterdam, Amsterdam; National Institute of Public Health and the Environment, Bilthoven; Biometrics, Wageningen University and Research Centre, Wageningen, the Netherlands.J. van den Hoek, MSc, Amsterdam Rehabilitation Research Center | Reade, and Department of Social Medicine, Academic Medical Center, University of Amsterdam; L.D. Roorda, MD, PT, PhD, Amsterdam Rehabilitation Research Center | Reade; H.C. Boshuizen, PhD, National Institute of Public Health and the Environment, and Biometrics, Wageningen University and Research Centre; G.J. Tijhuis, MD, PhD, Amsterdam Rehabilitation Research Center | Reade; G.A. van den Bos, PhD, Department of Social Medicine, Academic Medical Center, University of Amsterdam; J. Dekker, PhD, Amsterdam Rehabilitation Research Center | Reade, and Departments of Rehabilitation and Psychiatry, EMGO Institute, VU University Medical Center Amsterdam.
Abstract
OBJECTIVE: To investigate the longterm association of a wide range of comorbidities with physical and mental functioning in patients with rheumatoid arthritis (RA). METHODS: Longitudinal data over a period of 11 years were collected from 882 patients with RA. Somatic comorbidity and comorbid depression were measured at baseline, with a questionnaire including 20 chronic diseases and with the Center for Epidemiologic Depression Scale, respectively. Physical functioning was measured at 5 timepoints with a disease-specific measure [Health Assessment Questionnaire (HAQ)] and a generic measure [physical scales of the Medical Outcomes Study Short Form-36 (SF-36)]. Mental functioning was measured with the mental scales of the SF-36. To determine the association of baseline-specific comorbidities with functioning over time, we performed longitudinal analyses. RESULTS: At baseline, 72% percent of the patients were women, mean age ± SD was 59.3 ± 14.8 years, median RA disease duration was 5.0 years, and 68% had ≥ 1 comorbid condition. The effect of comorbid conditions was more apparent when physical functioning was measured with SF-36, a disease-generic measure, compared with the HAQ, a disease-specific measure. Circulatory conditions and depression were associated (p < 0.05) with worse physical functioning according to the HAQ. Respiratory conditions, musculoskeletal conditions, cancer, and depression were associated (p < 0.05) with worse physical functioning according to the SF-36. Respiratory conditions and depression were associated with worse mental functioning. CONCLUSION: Patients with specific comorbid conditions have an increased risk of low functioning in the long term. Targeted attention for these specific comorbid conditions by clinicians is recommended.
OBJECTIVE: To investigate the longterm association of a wide range of comorbidities with physical and mental functioning in patients with rheumatoid arthritis (RA). METHODS: Longitudinal data over a period of 11 years were collected from 882 patients with RA. Somatic comorbidity and comorbid depression were measured at baseline, with a questionnaire including 20 chronic diseases and with the Center for Epidemiologic Depression Scale, respectively. Physical functioning was measured at 5 timepoints with a disease-specific measure [Health Assessment Questionnaire (HAQ)] and a generic measure [physical scales of the Medical Outcomes Study Short Form-36 (SF-36)]. Mental functioning was measured with the mental scales of the SF-36. To determine the association of baseline-specific comorbidities with functioning over time, we performed longitudinal analyses. RESULTS: At baseline, 72% percent of the patients were women, mean age ± SD was 59.3 ± 14.8 years, median RA disease duration was 5.0 years, and 68% had ≥ 1 comorbid condition. The effect of comorbid conditions was more apparent when physical functioning was measured with SF-36, a disease-generic measure, compared with the HAQ, a disease-specific measure. Circulatory conditions and depression were associated (p < 0.05) with worse physical functioning according to the HAQ. Respiratory conditions, musculoskeletal conditions, cancer, and depression were associated (p < 0.05) with worse physical functioning according to the SF-36. Respiratory conditions and depression were associated with worse mental functioning. CONCLUSION:Patients with specific comorbid conditions have an increased risk of low functioning in the long term. Targeted attention for these specific comorbid conditions by clinicians is recommended.
Authors: J van den Hoek; H C Boshuizen; L D Roorda; G J Tijhuis; M T Nurmohamed; G A M van den Bos; J Dekker Journal: Rheumatol Int Date: 2016-12-28 Impact factor: 2.631