Assessing joint pain complaints and locomotor disability in the Rotterdam study: Effect of population selection and assessment mode

Objective: To assess the prevalence of self-assessed and physician- assessed disability and joint pain, their association, and the effect of cohort reduction and mode of assessment. Design: Cross-sectional population survey. Setting: General population, age 55 years and older. Subjects: Independently living participants of the Rotterdam Study, including 1,156 men and 1,739 women. Outcome Measures: Self-reported and physician-assessed joint complaints. Patients' self-assessment of locomotor disability was by response to questions from the Stanford Health Assessment Questionnaire; physicians assessed patients' disability by administering activity tests. Results: Reduction of the study cohort because of nonresponse and missing data had no influence on the frequency and effect measures. The physician-assessed prevalence of pain of the hips, knees, or feet was significantly lower than the self-assessed prevalence, with the percentage agreement being 83% for men and 74% for women, with kappa-values of approximately 140. The prevalence of physician-assessed locomotor disability was also significantly lower than the self-assessed disability, with the percentage agreement being 83% for men and 78% for women, with kappa values of .41 and .47, respectively. The associations of joint complaints with disability were similar for both modes of assessment. Conclusion: Cohort reduction caused by nonresponse and missing data had no influence on estimates of frequency and association. Self- assessment gives higher prevalences of joint complaints and locomotor disability than physician assessment, but the associations between complaints and disability were the same. (C) 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.

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