Determinants of Health-Related Quality of Life in Older Adults With Rheumatoid Arthritis: A Cross-Sectional Study in...

With increasing life expectancy, noncommunicable diseases such as rheumatoid arthritis (RA) are major contributors to reduced health-related quality of life (HRQOL) among older adults. This study aimed to identify demographic and clinical factors associated with HRQOL in older adults with RA in northern Iran.

In this cross-sectional analytical study, 94 RA patients aged ≥ 60 years were recruited from the only government rheumatology clinic in Rasht, northern Iran. Disease activity was evaluated using the Disease Activity Score in 28 joints (DAS28), which incorporates the erythrocyte sedimentation rate (ESR). HRQOL was measured with the EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) questionnaire (range: -0.594 to 1.000). Body mass index (BMI) was categorized as normal (≤ 25), overweight (> 25), or obese (> 30). Demographic and health-related data were also collected.

Moderate RA severity predominated (58.51%). The mean DAS28 and EQ-5D-5L index scores were 3.98 ± 1.1 and 0.583 ± 0.253, respectively. HRQOL was significantly associated with age (H = 10.512, p = 0.005), education (H = 14.306, p = 0.003), urban residence (U = 703.500, p = 0.006), and occupation (H = 7.833, p = 0.030). Disease activity severity was significantly inversely correlated with HRQOL (r = -0.566, p < 0.001). Multiple regression confirmed disease activity severity (β = -0.101, 95% CI: -0.137 to -0.065; p < 0.001) and urban residence (β = 0.086, 95% CI: 0.011 to 0.161; p = 0.025) as key predictors.

Identifying and addressing modifiable factors such as disease activity and geographic disparities may guide interventions to improve quality of life in older adults with RA.