Hand problems in community-dwelling older adults: onset and effect on global physical function over a 3-year period

Objective. To determine the impact of the onset of hand problems on global physical functioning in community-dwelling older adults. Methods. Three-year follow-up postal survey of a population sample of older adults (50 yrs and over) previously recruited to the North Staffordshire Osteoarthritis Project. Questionnaires at baseline and 3-yr collected data on joint pain in the past 12 months in the hands and lower limbs, and physical functioning [SF-36 subscale (PF-10)]. Onset of hand problems at 3 yrs was determined in two subgroups: (i) those free from hand problems and lower limb pain at baseline (n = 762) and (ii) those free from hand problems but with lower limb pain at baseline (n = 754). Changes in PF-10 scores from baseline to 3 yrs were examined in these two subgroups. Results. Onset of hand problems was similar in the two subgroups (20.6 and 24.3% in those without and with baseline lower limb pain, respectively). Females had a higher onset than males but age had little influence. Significantly greater mean change in PF-10 scores was seen in those who reported hand problem onset compared with persons who remained free of hand problems; 8.47 vs 4.62 and 4.78 vs 1.08 in those without and with baseline lower limb pain, respectively. Conclusions. The development of hand problems has a detrimental effect on global physical functioning even in the absence of concurrent lower limb problems. The assessment and effective treatment of hand problems could prove to be important components of maintaining function in the older adult with joint pain and OA.