Functional Disability Among Indian Rheumatoid Arthritis Patients and Its Association with Disease Severity: A Hospital-based Cross-sectional Study

Background: Rheumatoid arthritis (RA) is a polyarthritis classically affecting bilateral and symmetrical joints. Although a progressive disease, RA patients experience high and low disease activity phases, which are reflected in symptoms and functional ability. Any worsening of the illness results in permanent changes to the joints. This study was conducted to assess the functional disability among patients with RA, to elicit its association with selected sociodemographic and clinical variables and with disease activity. Methods: A cross-sectional study was conducted by a convenience sampling method, amongst 400 consenting RA patients, visiting the rheumatology outpatient department (OPD) of the hospital. Sociodemographic and clinical data were taken and their functional disability. Background: RA is a polyarthritis classically affecting bilateral and symmetrical joints. Although a progressive disease, RA patients experience high and low disease activity phases, which are reflected in symptoms and functional ability. Any worsening of the illness results in permanent changes to the joints. This study was conducted to assess the functional disability among patients with RA, to elicit its association with selected sociodemographic and clinical variables and with disease activity. Methods: A cross-sectional study was conducted by convenience sampling method, amongst 400 consenting RA patients, visiting the rheumatology OPD of the hospital. Sociodemographic and clinical data were taken and their functional disability assessed using Health Assessment Questionnaire Disability Index (HAQ-DI) score and its association with the variables of disease activity studied using the Disease Activity Score 28 (DAS28) scale, from June 2022 to July 2024. Results: The mean age of the study participants was 50.2 ± 10.48 years; 86.4% of them were females. The mean HAQ-DI score was 0.70 ± 0.83. The eating and hygiene component of the eight domains studied in HAQ-DI was most affected in RA patients in this study. Functional disability was found to be significantly associated with a higher total cholesterol/high density lipoprotein (TC/HDL) ratio and measures of disease activity. Conclusion: This study found functional limitations in all domains with eating and personal hygiene being the most prevalent; similarly, higher TC/HDL ratio and disease severity were also associated with higher functional disability. These domains and risk factors being modifiable, can help physicians in early identification and prevention of disability.