EFFECT OF RHEUMATOID-ARTHRITIS ON WORK STATUS AND SOCIAL AND LEISURE-TIME ACTIVITIES IN PATIENTS FOLLOWED 8 YEARS FROM ONSET

Objective. To evaluate the development of handicap in patients with rh eumatoid arthritis (RA) followed 8 years from onset. Methods. The stud y group consisted of 106 patients participating in a prospective early RA study. The mean duration of joint symptoms at inclusion was one ye ar. The patients were assessed at least once annually, Disability was measured with the Health Assessment Questionnaire (HAQ) and emotional distress with a self-administered test (Symptom Checklist). Work statu s and different social measures were registered. A structured intervie w regarding work capacity, leisure time, and social activities was per formed about 8 years after disease onset. Results. Compared to study s tart, disease activity had decreased, emotional distress was unchanged , disability had increased somewhat, and radiographic changes had incr eased markedly. The prevalence of work disability at the end of the st udy was 37%. The majority of patients that eventually got disability p ension had stopped working the first year after onset. Seventy-eight p ercent of the patients who continued to work had to adjust their work conditions to stay employed. The 3 most important predictors for work disability were higher HAQ at study start, lower educational level, an d older age. Three-quarters of the patients had to alter leisure time activities and half of them were not satisfied with their recreation, Many patients experienced difficulties in their roles as spouse and pa rent. Higher levels of emotional distress were associated with these h andicaps. Conclusion. In this cohort of patients with RA we found a hi gh frequency of different types of handicaps at an early stage. Slight ly more than 1/3 were work disabled. The majority had stopped working during the first year. Patients perceived handicaps in terms of change d leisure time activities, and difficulties performing different socia l roles were frequent. Patients with these handicaps felt more emotion al distress.