Prevalence and determinants of one month hand pain and hand related disability in the elderly (Rotterdam study)

Objective: To study the prevalence of hand pain and hand disability in an open population, and the contribution of their potential determinants. Methods: Baseline data were used from 7983 participants in the Rotterdam study (a population based study in people aged ⩾55 years). A home interview was used to determine the presence of hand pain during the previous month, rheumatoid arthritis, osteoarthritis in any joint, diabetes, stroke, thyroid disease, neck/shoulder pain, gout, history of fracture in the past five years, and Parkinson’s disease, as well as age, sex, and occupation. Hand disability was defined as the mean score of eight questions related to hand function. Body mass index was measured and hand x rays were taken. Results: The one month period prevalence of hand pain was 16.9%. The prevalence of hand disability was 13.6%. In univariate analysis for hand pain, rheumatoid arthritis had the highest explained variance (R2) and odds ratio. For hand disability, aging showed the highest explained variance and Parkinson’s disease had the highest odds ratio. All determinants together showed an explained variance of 19.8% for hand pain and 25.2% for hand disability. In multivariate analysis, positive radiographic hand osteoarthritis was a poor explanation for hand pain (R2 = 0.5%) or hand disability (R2 = 0). Conclusions: The contribution of available potential determinants in this study was about 20% for hand pain and 25% for hand disability in an unselected population of elderly people. Thus a greater part of hand pain/hand disability remains unexplained.

[1]  S. Jacobelli,et al.  Hypothalamic-pituitary-adrenal axis function in patients with active rheumatoid arthritis: a controlled study using insulin hypoglycemia stress test and prolactin stimulation. , 1999, The Journal of rheumatology.

[2]  A. Hudson,et al.  Persistence of Chlamydia trachomatis Is Induced by Ciprofloxacin and Ofloxacin In Vitro , 2000, Antimicrobial Agents and Chemotherapy.

[3]  C. Cooper,et al.  Smoking and musculoskeletal disorders: findings from a British national survey , 2003, Annals of the rheumatic diseases.

[4]  T. Lehner,et al.  Different cross-reacting circulating immune complexes in Behçet's syndrome and recurrent oral ulcers. , 1981, The Journal of laboratory and clinical medicine.

[5]  P. Ingvarsson,et al.  Disturbed grip function in women with rheumatoid arthritis. , 2001, The Journal of rheumatology.

[6]  I. Adcock,et al.  Defective glucocorticoid receptor nuclear translocation and altered histone acetylation patterns in glucocorticoid-resistant patients. , 2004, The Journal of allergy and clinical immunology.

[7]  Bonnie Bruce,et al.  The Stanford Health Assessment Questionnaire: Dimensions and Practical Applications , 2003, Health and quality of life outcomes.

[8]  C. Sweep,et al.  Similar response of adrenocorticotrophic hormone, cortisol and prolactin to surgery in rheumatoid arthritis and osteoarthritis. , 1998, British journal of rheumatology.

[9]  K. Sakamoto,et al.  Judgment of disability stages in Parkinson disease patients due to pathological tremor of index finger. , 2000, Electromyography and clinical neurophysiology.

[10]  W. Graninger,et al.  Anterior pituitary function in patients with newly diagnosed rheumatoid arthritis. , 1996, British journal of rheumatology.

[11]  C. Helmick,et al.  Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. , 1998, Arthritis and rheumatism.

[12]  H. Yazıcı,et al.  Papulopustular skin lesions are seen more frequently in patients with Behçet's syndrome who have arthritis: a controlled and masked study , 2001, Annals of the rheumatic diseases.

[13]  H. Nagafuchi,et al.  Fine antigen specificity of human gamma delta T cell lines (V gamma 9+) established by repetitive stimulation with a serotype (KTH-1) of a gram-positive bacterium, Streptococcus sanguis. , 1994, European journal of immunology.

[14]  B. Dellhag,et al.  A five-year followup of hand function and activities of daily living in rheumatoid arthritis patients. , 1999, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[15]  Michelle Urwin,et al.  Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation , 1998, Annals of the rheumatic diseases.

[16]  Å. Kilbom,et al.  Risk factors for neck and upper limb disorders: results from 24 years of follow up. , 1999, Occupational and environmental medicine.

[17]  Y. Suga,et al.  A case of Behçet's disease aggravated by gingival infection with methicillin‐resistant Staphylococcus aureus , 1995, The British journal of dermatology.

[18]  S. Keinänen-Kiukaanniemi,et al.  Rheumatic pains of previously undiagnosed diabetic subjects. , 1995, Scandinavian journal of rheumatology.

[19]  R. Acheson Heberden Oration 1981: epidemiology and the arthritides. , 1982, Annals of the rheumatic diseases.

[20]  M. Cohen,et al.  Failure of insulin hypoglycemia to produce rise in serum prolactin. , 1975, American journal of obstetrics and gynecology.

[21]  C. Dillon,et al.  Self-reported hand and wrist arthritis and occupation: data from the U.S. National Health Interview Survey-Occupational Health Supplement. , 2002, American journal of industrial medicine.

[22]  P. Brooks,et al.  The clinical and immunological effects of pulse methylprednisolone therapy in rheumatoid arthritis. II. Effects on immune and inflammatory indices in peripheral blood. , 1988, The Journal of rheumatology.

[23]  C. Sweep,et al.  Decreased prolactin response to hypoglycaemia in patients with rheumatoid arthritis: correlation with disease activity , 2004, Annals of the rheumatic diseases.

[24]  B. Dijkmans,et al.  Three month treatment of reactive arthritis with azithromycin: a EULAR double blind, placebo controlled study , 2004, Annals of the Rheumatic Diseases.

[25]  P. Diggle,et al.  Analysis of Longitudinal Data , 2003 .

[26]  M. Shipley,et al.  A DOUBLE-BLIND PLACEBO-CONTROLLED TRIAL OF METHYLPREDNISOLONE PULSE THERAPY IN ACTIVE RHEUMATOID DISEASE , 1982, The Lancet.

[27]  L. V. D. van de Putte,et al.  Treatment of rheumatoid arthritis with the dopamine agonist quinagolide. , 1999, The Journal of rheumatology.

[28]  H. Zeidler,et al.  Effects of Azithromycin and Rifampin onChlamydia trachomatis Infection In Vitro , 2001, Antimicrobial Agents and Chemotherapy.

[29]  R. Deremee,et al.  Wegener's granulomatosis: observations on treatment with antimicrobial agents. , 1985, Mayo Clinic proceedings.

[30]  M. Hochberg,et al.  New radiographic grading scales for osteoarthritis of the hand. Reliability for determining prevalence and progression. , 1989, Arthritis and rheumatism.

[31]  T. Lehner,et al.  DETECTION OF RNA COMPLEMENTARY TO HERPES-SIMPLEX VIRUS IN MONONUCLEAR CELLS FROM PATIENTS WITH BEHÇET'S SYNDROME AND RECURRENT ORAL ULCERS , 1982, The Lancet.

[32]  C. Kallenberg,et al.  Neutrophil activation in vitro and in vivo in Wegener's granulomatosis. , 1994, Kidney international.

[33]  S. Kiraz,et al.  The effect of prophylactic penicillin treatment on the course of arthritis episodes in patients with Behçet's disease. A randomized clinical trial. , 1996, Arthritis and rheumatism.

[34]  K. Pile,et al.  Evaluation of hand function in patients undergoing long term haemodialysis , 2001, Annals of the rheumatic diseases.

[35]  R. Hirsch,et al.  Association of hand and knee osteoarthritis: evidence for a polyarticular disease subset. , 1996, Annals of the rheumatic diseases.

[36]  J. Gaston,et al.  Clinical and experimental evidence for persistent Yersinia infection in reactive arthritis. , 1999, Arthritis and rheumatism.

[37]  G. Hatemi,et al.  The pustular skin lesions in Behçet’s syndrome are not sterile , 2004, Annals of the rheumatic diseases.

[38]  P. Brooks,et al.  The clinical and immunological effects of pulse methylprednisolone therapy in rheumatoid arthritis. I. Clinical effects. , 1988, The Journal of rheumatology.

[39]  J M W Hazes,et al.  Prevalence of self reported musculoskeletal diseases is high , 2003, Annals of the rheumatic diseases.

[40]  A. N. Corps,et al.  Ciprofloxacin enhances the stimulation of matrix metalloproteinase 3 expression by interleukin-1beta in human tendon-derived cells. A potential mechanism of fluoroquinolone-induced tendinopathy. , 2002, Arthritis and rheumatism.

[41]  S. Kiraz,et al.  Parvovirus B19 infection in Behçet's disease , 2001, Clinical and experimental rheumatology.

[42]  A. Silman,et al.  Should infection still be considered as the most likely triggering factor for rheumatoid arthritis? , 2003, The Journal of rheumatology.

[43]  D. Klinman Does activation of the innate immune system contribute to the development of rheumatoid arthritis? , 2003, Arthritis and rheumatism.

[44]  I. Fresko,et al.  Target organ associations in Turkish patients with Behçet's disease: a cross sectional study by exploratory factor analysis. , 2002, The Journal of rheumatology.

[45]  T. Lehner,et al.  Association between the 65-kilodalton heat shock protein, Streptococcus sanguis, and the corresponding antibodies in Behçet's syndrome , 1991, Infection and immunity.

[46]  M. Relling,et al.  Recombinant urate oxidase for the prophylaxis or treatment of hyperuricemia in patients With leukemia or lymphoma. , 2001, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[47]  R. Bergman,et al.  Alopecia areata and relapsing polychondritis or mosaic autoimmunity? The first experience of co-trimoxazole treatment , 2003, Annals of the rheumatic diseases.

[48]  A. Tausche,et al.  Severe gouty arthritis refractory to anti-inflammatory drugs: treatment with anti-tumour necrosis factor α as a new therapeutic option , 2004, Annals of the rheumatic diseases.

[49]  J. O'duffy Behcet's disease. , 1981, Minnesota medicine.

[50]  H. Gérard,et al.  Synovial Chlamydia trachomatis in patients with reactive arthritis/Reiter's syndrome are viable but show aberrant gene expression. , 1998, The Journal of rheumatology.

[51]  A. Hofman,et al.  Associations of radiological osteoarthritis of the hip and knee with locomotor disability in the Rotterdam Study , 1998, Annals of the rheumatic diseases.

[52]  E. Carmeli,et al.  The aging hand. , 2003, The journals of gerontology. Series A, Biological sciences and medical sciences.

[53]  Hirohata,et al.  Abnormal T cell responses to bacterial superantigens in Behçet's disease (BD) , 1998, Clinical and experimental immunology.

[54]  K. Eberhardt,et al.  Functional impairment and disability in early rheumatoid arthritis--development over 5 years. , 1995, The Journal of rheumatology.

[55]  S. Ono,et al.  [Studies on the constitution and past history of patients with Behcet's disease]. , 1972, Nippon Ganka Gakkai zasshi.

[56]  T. Harris Invited commentary: body composition in studies of aging: new opportunities to better understand health risks associated with weight. , 2002, American journal of epidemiology.

[57]  Pulse Methylprednisolone Therapy in Rheumatoid Arthritis , 1988 .

[58]  F. Houssiau,et al.  A randomised comparative study of the short term clinical and biological effects of intravenous pulse methylprednisolone and infliximab in patients with active rheumatoid arthritis despite methotrexate treatment , 2004, Annals of the rheumatic diseases.

[59]  R. Kalb Evaluation and treatment of wrist and hand pain. , 1998, Hospital practice.

[60]  T. H. Steele,et al.  Hyperuricemic nephropathies. , 1999, Nephron.

[61]  Keith T Palmer Regional musculoskeletal conditions: pain in the forearm, wrist and hand. , 2003, Best practice & research. Clinical rheumatology.

[62]  S. Jalkanen,et al.  Salmonella lipopolysaccharide in synovial cells from patients with reactive arthritis , 1990, The Lancet.

[63]  Keith T Palmer,et al.  Pain in the forearm, wrist and hand , 2003 .

[64]  J. Carter,et al.  Doxycycline versus doxycycline and rifampin in undifferentiated spondyloarthropathy, with special reference to chlamydia-induced arthritis. A prospective, randomized 9-month comparison. , 2004, The Journal of rheumatology.

[65]  S. Kiraz,et al.  Effect of prophylactic benzathine penicillin on mucocutaneous symptoms of Behçet's disease. , 1996, Dermatology.

[66]  H. Schröder,et al.  [The treatment of essential hyperuricemia in graduated programs]. , 1984, Zeitschrift fur arztliche Fortbildung.

[67]  M H Liang,et al.  Comparative measurement efficiency and sensitivity of five health status instruments for arthritis research. , 1985, Arthritis and rheumatism.

[68]  P. van Riel,et al.  Sensitivity of a Dutch Health Assessment Questionnaire in a Trial Comparing Hydroxychloroquine vs. Sulphasalazine , 1990 .

[69]  B. Baethge,et al.  Excitatory amino acids, TNF‐α , and chemokine levels in synovial fluids of patients with active arthropathies , 2004, Clinical and experimental immunology.

[70]  S. Mackinnon,et al.  Prevalence of Smoking, Obesity, Diabetes Mellitus, and Thyroid Disease in Patients With Carpal Tunnel Syndrome , 2002, Annals of plastic surgery.

[71]  Blair H. Smith,et al.  The epidemiology of chronic pain in the community , 1999, The Lancet.

[72]  A. Hofman,et al.  Determinants of disease and disability in the elderly: The Rotterdam elderly study , 1991, European Journal of Epidemiology.

[73]  O. Wilder‐Smith,et al.  The management of chronic pain in Switzerland: A comparative survey of Swiss medical specialists treating chronic pain , 2001, European journal of pain.

[74]  T. Lehner,et al.  Immune complexes in Behçet's syndrome and recurrent oral ulceration. , 1977, British medical journal.

[75]  F. Hiepe,et al.  No benefit of long-term ciprofloxacin treatment in patients with reactive arthritis and undifferentiated oligoarthritis: a three-month, multicenter, double-blind, randomized, placebo-controlled study. , 1999, Arthritis and rheumatism.

[76]  A. Cats,et al.  Measurement of disability in Dutch rheumatoid arthritis patients , 1984, Clinical Rheumatology.

[77]  R. Hirsch,et al.  Prevalence of rheumatoid arthritis in persons 60 years of age and older in the United States: effect of different methods of case classification. , 2003, Arthritis and rheumatism.

[78]  D. Jezova,et al.  Somatotropic, Lactotropic and Adrenocortical Responses to Insulin‐Induced Hypoglycemia in Patients with Rheumatoid Arthritis , 2002, Annals of the New York Academy of Sciences.

[79]  P. Saikku,et al.  Double-blind, placebo-controlled study of three-month treatment with lymecycline in reactive arthritis, with special reference to Chlamydia arthritis. , 1991, Arthritis and rheumatism.

[80]  R. Helme,et al.  The epidemiology of pain in elderly people. , 2001, Clinics in geriatric medicine.

[81]  F. Kaneko,et al.  Streptococcal infection in the pathogenesis of Behçet's disease and clinical effects of minocycline on the disease symptoms. , 1997, Yonsei medical journal.

[82]  S. Walker,et al.  Roles of prolactin and gonadotropin-releasing hormone in rheumatic diseases. , 2000, Rheumatic diseases clinics of North America.

[83]  R. Hirsch,et al.  Familial aggregation of osteoarthritis: data from the Baltimore Longitudinal Study on Aging. , 1998, Arthritis and rheumatism.

[84]  F. Máliš,et al.  Prolactin and growth hormone responses to hypoglycemia in patients with rheumatoid arthritis and ankylosing spondylitis. , 2004, The Journal of rheumatology.

[85]  A. Weiland,et al.  Gouty tenosynovitis in the hand. , 1985, The Journal of hand surgery.

[86]  M. Ahern,et al.  Neutrophil trafficking into inflamed joints in patients with rheumatoid arthritis, and the effects of methylprednisolone. , 1996, Arthritis and rheumatism.

[87]  J. Fries,et al.  The dimensions of health outcomes: the health assessment questionnaire, disability and pain scales. , 1982, The Journal of rheumatology.