A five-year followup of hand function and activities of daily living in rheumatoid arthritis patients.

OBJECTIVE To follow hand function and activity of daily living (ADL) capacity prospectively during a 5-year period in a cohort of outpatients with rheumatoid arthritis (RA). METHODS Forty-three patients (28 women, 15 men), mean age 53.7 years and mean disease duration 7.5 years, were included. The Grip Ability Test (GAT), grip strength, the Keitel Function Test (KFT), the Health Assessment Questionnaire (HAQ), self-estimated hand function, and pain scales were used. Need of personal assistance in the HAQ components was recorded as ADL dependence. RESULTS After 5 years, the GAT, the KFT, and 3 HAQ components were significantly worse in women. Improved GAT was the only significant change in men. An additional 12 patients needed personal ADL assistance, bringing the total to 21 patients (49%). CONCLUSIONS Hand function deteriorated during a 5-year period in female RA patients. Hand disability (GAT) improved in the male RA group, although hand impairment (grip strength, KFT) was unchanged. Over one-fourth of each gender group had developed a new handicap (dependence).