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Disability In Older Adults With Arthritis And Differences Among Racial Groups
02 Aug 2007
As edited by Joint-Pain-Forum.com
Arthritis is common among elderly Americans, and as the
population ages it is expected to increase. At the same time,
disability is increasing in patients with arthritis and the
racial/ethnic composition of the U.S. is changing; minority populations
are forecasted to increase from 30.6 percent of the population in 2000
to 49.9 percent by 2050. A new study published in the August issue of Arthritis Care & Research examined
the rates at which different racial groups develop disability, how
differences between groups can be accounted for, and the significant
risk factors that predict the development of disability among older
adults with arthritis..
Led by Jing Song of Northwestern University Feinberg School of
Medicine in Chicago, IL, researchers examined data from the 1998-2004
Health and Retirement Study (HRS), a national study of
noninstitutionalized older Americans. Using information from 1998,
2000, 2002 and 2004, their analysis included 7,257 respondents who
reported arthritis and were initially disability free. The group was
comprised of 85.5 percent whites, 9.3 percent African Americans, 2.4
percent Hispanics who spoke Spanish and 2.9 percent Hispanics who spoke
English. Respondents were questioned as to whether they had arthritis,
and disability was established by an inability (after the initial
interview) to perform at least one task in the activities of daily
living (ADL) as defined by the HRS: dressing, walking across a room,
getting in or out of bed, bathing, eating and toileting.
The results showed that 1 out of 6 people
reported disability in at least one ADL task over the 6-year follow-up
period, but there were substantial differences across race/ethnicity
groups. The rates of ADL disability among African Americans and
Hispanic/Spanish were almost twice that of whites; Hispanic/English had
rates similar to whites. The study differentiated between Hispanics who
spoke English and those who spoke Spanish in order to consider whether
adapting to a new culture (as measured by language) can affect health
status. The authors note that language barriers may limit educational
and occupational choices, and social stress related to poverty may
contribute to the greater disability experienced by the
Hispanic/Spanish group.
The study investigated the influence of health and medical
access on racial/ethnic differences in developing disability and found
that the differences were due to other chronic health conditions,
functional limitation (such as an inability to walk several blocks),
and health behaviors (such as smoking, alcohol consumption and regular
exercise). Medical access also substantially influenced differences in
the development of disability. In addition to having fewer economic
resources, minorities were more likely to be uninsured or rely on
Medicaid coverage. The authors note that lack of private insurance may
indicate poorer quality of health care received and that those with
lower tier health plans commonly have fewer choices regarding health
services, which can compromise their quality of care.
The authors acknowledge that the study included self-reported
arthritis, did not include information on the severity of the
condition, and that the findings might have been influenced by
unmeasured factors such as occupation, job demands, poorer living
conditions and segregation. Nonetheless, the results showed that among
older adults with arthritis, differences among racial groups in
developing disabilities was largely due to differences in health status
and medical access. "At the clinical level, not only should treatment
of comorbid conditions be considered, but also disease prevention,
prevention and treatment of functional limitations, and promotion of
healthy behaviors should be a priority for all patients with arthritis
to prevent the development of disability," the authors conclude.
"Future research should be directed at how to more effectively deliver
such programs especially to minority populations."
----------------------------
Article adapted by Joint-Pain-Forum.com from original press release.
----------------------------
Article: "Racial/Ethnic Differences in Activities of Daily Living
Disability in Older Adults with Arthritis: A Longitudinal Study," Jing
Song, Huan J. Chang, Manasi Tirodkar, Rowland W. Chang, Larry M.
Manheim, Dorothy D. Dunlop, Arthritis Care & Research, August 2007; (DOI: 10.1002/art.22906).
Source: Amy Molnar
John Wiley & Sons, Inc.
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