Quality of Life in Long-Standing Rheumatoid Arthritis: What Can Help Apart from Treatment? A Single-Center Cross-Sectional Observational Study

<b>Background:</b> Rheumatoid arthritis (RA) is characterized by pain, limited mobility, an increased risk of depression, and sleep disturbances, which significantly impact quality of life (QoL). Analyzing psychosocial and environmental factors can identify the most significant determinants of QoL in RA patients. <b>Methods:</b> We conducted a single-center cross-sectional observational study among RA patients with low disease activity (DAS28ESR ≤ 3.2) from September 2021 till May 2022 in a rheumatology clinic or biology ward during one-day follow-up visits. QoL in RA patients was analyzed using the World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF), the Beck Depression Inventory (BDI), and the Pittsburgh Sleep Quality Index (PSQI) using a backward stepwise multivariate regression model (heatmap). <b>Results:</b> A total of 116 patients were included, predominantly overweight females (76.7%), with a median disease duration of 19 years. Only 24% of patients had good sleep quality, while approximately 20% had risk factors for moderate to severe depression. WHOQOL-BREF scores indicated moderate physical health (median = 50), high psychological well-being (66.7), strong social relationships (75), a supportive environment (68.8), good overall QoL (75), and average overall health (50). The multivariate model revealed that younger patients (under 40 years of age), married individuals, and those with good sleep quality (as indicated by a low PSQI) had the highest scores in the various WHO-BREF domains. The physical activity level was positively correlated with overall QoL (<i>p</i> < 0.001) and overall health (<i>p</i> = 0.017). BMI and BDI values were negatively associated (pBMI < 0.05; pBDI < 0.001) with physical health (rBMI = -0.34; rBDI = -0.73), social relationships (rBMI = -0.19; rBDI = -0.73), psychological well-being (rBMI = -0.24; rBDI = -0.83), and overall health (rBMI = -0.26; rBDI = -0.46). <b>Conclusions:</b> This study shows that, in addition to appropriate treatment, maintaining good physical health, satisfying relationships, and ensuring quality sleep are crucial for improving the QoL of patients with RA.