Predictors of functional disability in Nigerians with osteoarthritis

Abstract

Background: Osteoarthritis (OA) is one of the leading causes of disability globally, resulting in limitation of walking and activities of daily living. Patients with OA frequently have to depend on devices and humans for assistance in carrying out activities of daily living. Disability associated with OA is attributed to pain. Other factors that may directly or indirectly contribute to this disability are poorly studied.

Objective: To determine factors other than pain that can predict functional disability in patients with OA.

Methods: The study was a crosssectional total population survey for musculoskeletal disorders carried out in Katon Rikkos, Jos, Nigeria. The survey was a phase 1 Community-Oriented Program for the Control of Rheumatic Diseases (COPCORD) study that included 2,454 adults aged 15 years or older. The diagnosis of osteoarthritis was based on the American College of Rheumatology (ACR) criteria for the classification of osteoarthritis, functional disability was estimated and graded using the HAQ-DI and data was analyzed using Statistical Package for the Social Sciences (SPSS) version 24.

Results: One hundred and fifty subjects were diagnosed with OA, 89 (59.3%) females and 61 (40.7%) males with a mean (SD) age of 51.8 (14.4) years. Mild to moderate disability was present in 125 (83.3%) of subjects, 24 (16.0%) had moderate to severe disability and only one subject had very severe disability. A disability score of ≥1, considered significant disability was recorded in 31 (20.7%) of subjects. Age, sleep disturbance, anxiety, hypertension, active straight leg raise and OA site were significantly associated with functional disability. Age correlated negatively with functional disability while sleep disturbance, anxiety, depression and hypertension were positive correlates. All except sleep disturbance added statistically significantly to the prediction on multiple regression, P < 0.05.

Conclusion: Anxiety, depression and hypertension are important predictors of disability in patients with osteoarthritis, therefore, these co-morbid conditions should be adequately sought for and managed in these patients to improve their outcome.

Keywords: Osteoarthritis, Functional disability, Nigerians, Predictors, Comorbidities