Changes in Health, Functional and Psychosocial Status and Coping Strategies of Home-Based Older Persons with Arthritis over Three Years

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Abstract
The population of persons over 65 years of age, both in simple headcount and in proportion of the total population of the United States, has been increasing dramatically since 1900. This trend is projected to continue at least until the middle of the next century. Approximately half of persons over 65 years of age experience pain and/or activity limitation as a result of arthritis. There has been little study of the changes over time in health, functional, and psychosocial status of elders with arthritis, nor of the coping strategies they employ. Using participants from the University at Buffalo Consumer Assessments Study, we retrospectively selected 61 cognitively intact Mini Mental Status Exam (MMSE>23) elders with arthritis that impacted on activities, who were living at home at an initial interview and at a three-year follow-up interview. Using paired ṯ-tests we found significant changes at the three-year follow-up in four measures of health status: number of medications, number of chronic illnesses, pain, and vision. Functional status declined significantly as measured by the FIM (using MANOVA for six sections of the FIM), the Sickness Impact Profile, and the IADL section of the OARS (using paired ṯ-tests). No significant changes were found for psychosocial status. Using MANOVA, we found a significant increase in numbers of assistive devices owned (from an initial mean of 14.7 to a three-year follow-up mean of 20.1), and number of devices used. Satisfaction with devices was high. Environmental problems in the home showed a significant increase over the three years. While our selection of study participants did not include individuals who went to nursing homes or hospitals, or who had died, we still found significant decline in health and functional status, and clear evidence of successful coping strategies. Results suggest a strong role for occupational therapy services for elders with arthritis. There is also a need for change in policy toward home modification and occupational therapy services.