Arthritis is associated with lower health-related quality of life (HRQoL) in adults aged 65 years and older who have one or more other chronic conditions, according to a study published in Preventing Chronic Disease.
The study led by researchers from Humana and the CDC, found that improving HRQoL in older adults enrolled in Medicare Advantage will depend upon managing both underlying chronic conditions and any accompanying arthritis.
For the study, HRQOL was measured using the CDC Healthy Days survey. After adjustment for potential confounders, individuals with a diagnosis of arthritis reported, on average, significantly more unhealthy days than were reported by individuals without arthritis: 13.8 vs 11.6 days P<.001. Individuals with arthritis reported both significantly more physically unhealthy days and significantly more mentally unhealthy days as well. Furthermore, among older adults with at least one of four other chronic conditions (congestive heart failure, chronic obstructive pulmonary disease, diabetes, or hypertension), those who also had arthritis reported significantly more activity-limited days and physically, mentally, and total unhealthy days than were reported by those without arthritis but with the same chronic conditions. According to the study’s authors, the findings have implications for disease management and population health programs.
“Arthritis is a prevalent condition in older adults,” says Eric Havens, a member of Humana’s Clinical Analytics team and the lead author of the paper. “Arthritis had been shown to be associated with diminished HRQOL in several studies of general adult populations. This study provided specific insight into the relationship between arthritis and HRQOL in older adults. This study is also unique in its exploration of the effect of arthritis on individuals with other specific chronic conditions.”
As noted in a paper recently published by the CDC and Humana, “HRQOL can be used to measure health disparities, track the influence of social determinants on overall health, and shed light on the ultimate impact of the health care system…As the health care systems shifts to a value-based purchasing model, individuals’ perceptions of their health are a critical element of defining value. Patient-reported assessments of their health such as Healthy Days should play an important role in determining where value is being delivered and should be reflected in reimbursement models.”
Based on the new study and other literature, there are 3 things to know about arthritis:
This research showed the effect of arthritis on HRQOL to be greater in older adults than previously observed in adults in general. Generic self-management and physical activity programs may be needed for this large population, and are likely to have positive effects for all five chronic conditions.
This new study has demonstrated the added effect of arthritis on quality of life in individuals who also have other chronic conditions, showing the importance of specifically addressing arthritis in existing chronic disease management programs.
The published evidence suggests that interventions to affect the social determinants of health should also include measures designed to help older adults manage their arthritis.