WHO disability assessment schedule 2.0 is related to upper and lower extremity disease-specific quality of life

Abstract

Purpose We evaluated whether two disease-specific quality of life instruments (Disabilities of the Arm, Shoulder and Hand, DASH and Western Ontario & McMaster Universities Osteoarthritis Index, WOMAC) reflect a patient's perception of general disability using the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) and determined whether disability components are explained by upper and lower extremity HRQOL. Methods We recruited 421 participants, 50 years or older without stroke, cancer, or history of surgery for musculoskeletal disease, who participated in the NAMGARAM Cohort. Upper extremity HRQOL was determined with the DASH score and lower extremity HRQOL with the WOMAC; as a measure of disability, we obtained WHODAS 2.0 component. Multiple regression modeling was used to assess the relative contributions made by upper and lower extremity HRQOL to disability. Results When adjusted for covariates, the DASH total score was correlated with getting around (beta = 0.217, p < 0.001) and social participation (beta = 0.226, p < 0.001), and the WOMAC total score was correlated with getting around (beta = 0.363, p < 0.001), life activation (beta=0.363, p < 0.001), and social participation (beta= 0.301, p < 0.001). QOL significantly correlated with upper extremity disorders (beta = 0.081, p = 0.018) or lower extremity disorders (beta = 0.095 p = 0.004). Conclusion We found that in a community-based population, perceived activity limitation and social participation were associated with upper and lower extremity HRQOL. Since the WHODAS 2.0 does not target a specific disease (as opposed to DASH and WOMAC), it can be used to compare disabilities caused by different diseases.