Functional Disability Tends to Affect Patients Before Official RA Diagnosis

Patients diagnosed with rheumatoid arthritis often are affected by functional disability a year or two before the disease is diagnosed, suggests research from the Mayo Clinic published in Mayo Clinic Proceedings.

Daily activities such as eating, dressing, and walking are affected early in the course of the disease, and most rheumatoid arthritis patients are affected by functional disability issues, according to the study.

“This is a new finding and a finding that is quite intriguing,” says Elena Myasoedova, MD, PhD, a Mayo Clinic rheumatologist and the study’s primary author, in a media release.

“It may reflect an accumulation of symptoms between the time of first onset and the time required for providers to actually diagnose patients.”

Persistent excess in functional disability continued even after diagnosis and treatment, Myasoedova says, which may be due to a growing burden of mental and physical pain, use of glucocorticoids and antidepressants, increasing expectations for relief from symptoms, and other factors.

The study aims to quantify the long-term trends in prevalence of functional disability in rheumatoid arthritis patients, with trends noted for patients’ ages and genders, as well as the length of time that disabilities were reported and the duration of the disease after diagnosis. The study also is the first to show that functional disabilities manifest one to two years prior to a rheumatoid arthritis diagnosis.

“These findings suggest that the burden of functional disability affects most patients with RA, begins early in the disease course, and may precede RA diagnosis,” the study says.

The retroactive, population-based study accessed information from the Rochester Epidemiology Project database of medical records, and examined questionnaires from 586 patients with rheumatoid arthritis and 531 people without the disease.

The prevalence of functional disability was more than twice as high in those with rheumatoid arthritis as those without. Patients with rheumatoid arthritis had a 15% or greater prevalence of functional disability than individuals without rheumatoid arthritis in most age groups, the release explains.

The study also highlights the importance of early treatment, Myasoedova notes.

“Alerting your health care provider to difficulties in daily living can assure that patients receive the help they need,” she says.

[Source(s): Mayo Clinic, EurekAlert]