Background: Rheumatoid Arthritis (RA) is characterized by chronic inflammation of joints with extra-articular systemic involvement. When managing RA, disease activity is assessed by (DAS28) score at regular intervals and treatment is changed according to disease activity. Although many studies have stressed upon DSA28 score to monitor improvement of RA on treatments, few studies have evaluated whether there is a concurrent improvement of the daily life functions and sleep of the patients or not
Aim of the work: To assess the relation between RA disease activity using DAS28 (ESR) score with functional status reflected by activities of daily living (ADLs) and sleep quality scores.
Patients and Methods: Fifty-four RA patients underwent history, clinical examination, investigation, and assessed for disease activity using DAS28 (ESR) score, basic and instrumental ADLs (BADLs & IADLs), and sleep quality by medical outcome study sleep scale (MOSS-S).
Results: Age of patients ranged from (20- 66) years with mean of 46.11 ± 10.19 years, disease duration ranged from (0.25- 28) years with mean of 5.5±2.5. The mean DAS28 was 4.63± 1.43. BADLs showed twenty-one patients with moderate impairment with a percent of 38.8%, and severe impairment in five patients with a percent of 9.2%. IADLs showed moderate impairment in twenty-five patients with a percent of 46.3% while there was no severe impairment. Highly significant correlation (r= 0.564, p-value < 0.01) was found between increased BADL score and increased IADL score, and between increased MOSS score and decreased BADL score (r=0.532, p-value < 0.01), and between decreased IADL score and MOSS score (r=0.485, p-value < 0.01).
Conclusion: Functional ADLs and sleep quality are strongly correlated with disease activity in RA patients and they are multifactorial in origin and related to pain, fatigue, depression, educational level and physical deformity.