Health-related quality of life in individuals aged 65 years and above with rheumatoid arthritis and general population controls
General Medicine, 2025, 27(4), 28-35.
E. Naseva1, 2, S. Neycheva3, E. Marinova4, V. Vodenicharov5
1 Department of Health Management and Health Economics, Faculty of Public Health “Prof. Tzecomir Vodenitcharov, MD, DSc”, Medical University ‒ Sofia
2 Medical Faculty, Sofia University “Sv. Kliment Ohridski”
3 Department of Rheumatology, Military Medical Academy – Sofia
4 Directorate of Public Health and Health Risk, National Center of Public Health and Analyses ‒ Sofia
5 Department of Epidemiology and Hygiene, Medical Faculty, Medical University ‒ Sofia
Abstract. Rheumatoid arthritis (RA) affects all areas of the patient physical and mental wellbeing. The disease leads to progressive joint damage. It is associated with chronic pain and significantly reduces quality of life. This article aims to compare the health-related quality of life of patients with RA aged 65 and older and individuals from the general population of the same age group (general population controls), as well as to assess if health-related quality of life decreases with ageing among 65+ years old individuals. Materials and Methods: Data from two studies were used, in which quality of life was assessed using the generic SF-36 questionnaire and its derivate SF-12. Samples were extracted from both groups, matched by sex and age, at a ratio of 2:1 general population controls to RA patients. The final sample consisted of 48 patients with RA, of whom 9 (18.8%) were men and 39 (81.3%) were women. The general population controls were 96, of whom 18 were men and 78 – women, at the same proportion. Results: We found that all domains of the scale showed significantly lower scores in patients with RA compared to the general population (p < 0,001 for all except mental health [MH] whose p = 0,001). Isolated cases from RA patients reached the maximum in only two domains, whilst general population controls often show results on the maximal values, excluding the general health domain (GH). Correlation analysis showed that age has a moderate negative correlation with the Physical Functioning (PF) domain only in the group of RA patients (Spearman’s rho = -0.341; p = 0.018). Conclusion: The clinical assessment made by the treating rheumatologist based solely on disease activity often differs from the real impact the disease has on all areas of life of patients with rheumatoid arthritis. When choosing a therapeutic approach, clinicians should consider the patient’s physical well-being, psychoemotional status, and social needs. This will ensure better outcomes that more closely meet the expectations and needs of the patients.
Key words: health-related quality of life, HRQoL, SF-36, SF-12, rheumatoid arthritis
Address for correspondence: Emilia Naseva, MD, e-mail: e.naseva@foz.mu- sofia.bg