Cited by 198Rheumatoid Arthritis Research and TherapiesHealth disparities and outcomesMusculoskeletal pain and rehabilitation

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Formal education as a marker for increased mortality and morbidity in rheumatoid arthritis

Pincus, Theodore, Callahan, Leigh F.·1985·Journal of Chronic Diseases

DOI 10.1016/0021-9681(85)90095-5

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Abstract

Increased mortality and morbidity was seen in association with lower formal educational levels in 75 rheumatoid arthritis (RA) patients over 9 years. Nine of the 20 patients with 8 or fewer years of education had died, compared to 10 of 34 with 9-12 years of education, and only one of 21 with more than 12 years of education. Among survivors with functional capacity data available from baseline and 9 year review, declines greater than 20% were seen in 8 of 10, 13 of 21, and 9 of 19 patients in the three education categories. Overall, 79% of grade-school educated, 43% of high-school educated, and 20% of college-educated patients had either died or declined more than 50% in functional capacity. Patients of different formal educational levels were similar at baseline in age, duration of disease, measures of functional capacity, number of involved hand joints, number of severe radiographic changes, use of gold, oral corticosteroids or other therapies, and associations between formal educational level and disease course are not explained by these variables. Formal educational level appears a simple quantitative marker which identifies a surrogate or composite variable associated with increased mortality and morbidity in RA.

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Lee, H.-Y., Kang, S., Shin, D. W., & Han, K. (2026) · RMD Open · doi:10.1136/rmdopen-2025-006345
Rheumatoid arthritis
Prasad, S., Friedman, M., Speisman, M., Hassan, R. S., Omatsone, C., Patel, A., Shahrara, S., Hanson, H. A., & Sweiss, N. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-45863-7.00079-2
Untitled work
Keefe (1996) · doi:10.1002/1529-0131(199608)9:4

Authors: Pincus, T., & Callahan, L. F.
Affiliations: Vanderbilt University (US)
Corresponding author: Pincus, Theodore
ORCID: Pincus, Theodore
Callahan, Leigh F.
Venue: Journal of Chronic Diseases
Publisher: Elsevier BV
Published: 1985-01
Volume: 38
Issue: 12
Pages: 973-984
ISSN: 0021-9681 (ISSN-L)
DOI: 10.1016/0021-9681(85)90095-5
OpenAlex: W2054433388
Cited by: 198
References: 39
Citations by year: 2026: 2 · 2025: 1 · 2024: 1 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 3 · 2018: 1 · 2017: 4 · 2016: 3 · 2015: 4 · 2014: 1 · 2013: 2 · 2012: 5
FWCI: 4.78
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Chronic Diseases (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (AM 22071)
Topics: Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
Social Sciences › Health › Health disparities and outcomes
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Keywords: rheumatoid arthritis, educational attainment, mortality, functional capacity, disease severity, socioeconomic factors, health disparities
MeSH terms: Activities of Daily Living, Adult, Aged, Arthritis, Rheumatoid, Educational Status, Female, Humans, Male, Middle Aged, Retrospective Studies, Tennessee

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Formal education as a marker for increased mortality and morbidity in rheumatoid arthritis

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