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Assessing joint pain complaints and locomotor disability in the Rotterdam study: effect of population selection and
E Odding1, H A Valkenburg, H J Stam
1Department of Epidemiology & Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.
Objective:
To assess the prevalence of self-assessed and physician-assessed disability and joint pain, their association, and the effect of cohort reduction and mode of assessment.
Design:
Cross-sectional population survey.
Setting:
General population, age 55 years and older.
Subjects:
Independently living participants of the Rotterdam Study, including 1,156 men and 1,739 women.
Outcome Measures:
Self-reported and physician-assessed joint complaints. Patients' self-assessment of locomotor disability was by response to questions from the Stanford Health Assessment Questionnaire; physicians assessed patients' disability by administering activity tests.
Results:
Reduction of the study cohort because of nonresponse and missing data had no influence on the frequency and effect measures. The physician-assessed prevalence of pain of the hips, knees, or feet was significantly lower than the self-assessed prevalence, with the percentage agreement being 83% for men and 74% for women, with kappa-values of approximately .40. The prevalence of physician-assessed locomotor disability was also significantly lower than the self-assessed disability, with the percentage agreement being 83% for men and 78% for women, with kappa values of .41 and .47, respectively. The associations of joint complaints with disability were similar for both modes of assessment.
Conclusion:
Cohort reduction caused by nonresponse and missing data had no influence on estimates of frequency and association. Self-assessment gives higher prevalences of joint complaints and locomotor disability than physician assessment, but the associations between complaints and disability were the same.