Key result
Specific baseline comorbidities, including circulatory, respiratory, musculoskeletal conditions, cancer, and depression, were associated with significantly worse long-term physical and/or mental functioning over 11 years in patients with rheumatoid arthritis.
Why the study?
Do specific baseline comorbidities worsen long-term physical and mental functioning in patients with rheumatoid arthritis?
Cohort (n=882)
Yes
Do specific baseline comorbidities worsen long-term physical and mental functioning in patients with rheumatoid arthritis?
p-value: p=<0.05
Specific baseline comorbidities, including circulatory conditions and depression, are associated with worse long-term physical and mental functioning in patients with rheumatoid arthritis.
May inform RA prognosis counseling; hypothesis-generating for targeted interventions.
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.
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Hoek et al. (2016) conducted a cohort in Rheumatoid Arthritis (n=882). Specific baseline comorbidities vs. Patients with RA without comorbidity was evaluated on Physical and mental functioning over time (measured by HAQ and SF-36) (p=<0.05). Specific baseline comorbidities, including circulatory, respiratory, musculoskeletal conditions, cancer, and depression, were associated with significantly worse long-term physical and/or mental functioning over 11 years in patients with rheumatoid arthritis.