Arthritis impact on the physical function, disability, and health-related quality of life among older Mexican-Americans
Saad M. Bindawas
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Background and Purpose: Arthritis is a major cause of disability with a sizable impact on health-related quality of life (HRQoL) in older adults, especially among older non-Hispanic white subjects. The purpose of this study is to examine the relation between arthritis and its effects on the physical function, disability, and health-related quality of life, over time, among older Mexican-Americans, the fastest growing subset of the older population. \r\nDesign: A six-year prospective cohort study (2000 to 2006). Setting: Five Southwestern states: Texas, New Mexico, Colorado, Arizona, and California. \r\nParticipants: A population-based sample of 621 non-institutionalized Mexican-Americans aged 65 or older from wave four of the Hispanic Established Population for Epidemiologic Studies of the Elderly (Hispanic EPESE). \r\nMeasurements: Included sociodemographic variables, self-reported of: arthritis, pain on weight-bearing, activities of daily living (ADL), instrumental activities of daily living (IADL), physical and mental HRQoL, medical conditions, cognitive function and depressive symptoms. Lower and upper extremity muscles strength, lower body function test and body mass index (BMI) were also obtained. General linear mixed models and generalized estimating equations (GEE) were used to examine the time effect on: 1) each stage of the disablement process and 2) physical and mental HRQoL over three points of time (2000-2001, 2001-2002, and 2006). This study conforms to STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guidelines for cohort studies. \r\nResults: The results indicate 1) a significant association between arthritis and greater impairment (pain and poor muscle strength), functional limitation, disability (ADL and IADL), and physical HRQoL across time; and 2) a significant association between impairment, functional limitation, and IADL limitation with physical and mental HRQoL across time. Conclusions: In older Mexican-Americans, arthritis is a highly prevalent medical condition which significantly impacts physical function, daily activities, and physical HRQoL over time. In this cohort, impairment, functional limitation, and disability were associated with poorer physical and mental HRQoL. These findings could guide efforts in reaching the goals of the National Arthritis Action Plan, as well as the Healthy People 2010 initiative goals of increasing quality of life and eliminating health disparities in this segment of the older U.S. population.