Arthritis in Children Leads to Worse Quality of Life Later

A recent study showed that adult patients who had had juvenile idiopathic arthritis (JIA) have a worse long-term health-related quality of life, compared with the general population. Physical disabilities, pain, fatigue, and well-being were the most affected aspects of quality of life.

In their study, the researchers evaluated 176 patients with JIA after 15 years and compared them with 90 matched controls. Patients were later reassessed with the Health Assessment Questionnaire Disability Index (HAQ-DI), Visual Analogue Scale (VAS) pain, and Medical Outcome Study 36-item Short Form (SF-36) after 23 and 30 years. Patients with signs of active disease after at least 15 years were examined again at 30 years.
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Results indicated that 82 patients had HAQ-DI scores higher than 0 and median VAS pain scores of 0.6 at 30-year follow-up. Both patients with and without clinical remission had lower physical component summary scores (PCS) vs controls. No differences in mental component summary scores were observed between groups.

Compared with controls, JIA patients also scored worse on all SF-36 subscales except mental health, and PCS scores worsened significantly between the 15- and 30-year follow-ups. Factors associated with lower PCS were worse HAQ-DI, VAS pain, patient's global assessment of wellbeing scores, and receiving disability and/or social living allowance at 30 years. Additionally, lower PCS scores at 30-year follow-up were predicted by worse HAQ-DI, patient's global assessment of well-being, and VAS fatigue at 15-year follow-up.

“JIA had a detrimental effect on physical [health-related quality of life] as measured by PCS,” the researchers concluded. “The strongest correlates were physical disabilities, pain, fatigue, well-being, and receiving disability/social living allowance.”

—Christina Vogt

Reference:

Tollisen A, Selvaag AM, Aulie HA, et al. Physical functioning, pain and health-related quality of life in adults with juvenile idiopathic arthritis: a longitudinal 30-year follow-up study [Published online July 21, 2017]. Arthritis Care Res. doi:10.1002/acr.23327.