The overarching aim of this study is to estimate the role of body composition in the development of functionalimitations and disability in both rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), withinthe context of a well-established model of disablement. Use of this model will facilitate a greaterunderstanding of the role of body composition in the development of disability, taking into account otherdisease, therapeutic, demographic, psychosocial, and behavioral factors that may contribute to or protectfrom disability. This project also represents the first attempt to characterize disability among persons withSLE across a wide range of life activities using the 'valued life activities' model of disability.
Specific aims are to: (1) examine the role of body composition in development of functional limitations and disability in SLEand RA, using an existing model of disablement; (2) identify risk and protective factors that interact with bodycomposition in the development of functional limitations and disability, or the maintenance of function andavoidance of disability, in RA and SLE; and (3) estimate the prevalence and incidence of disability in a widerange of life activities in a large group of individuals with SLE. Subjects for the proposed study will bemembers of the existing UCSF RA Panel and Lupus Outcomes Study (LOS). Existing study protocolsinclude annual telephone interviews with the cohorts through 2008, with an additional two years proposed inthe Methodology Core of this application. The proposed study will build upon this by adding project-specificmeasures to the annual telephone interviews, and adding two in-person assessments at the UCSF GeneralClinical Research Center (GCRC) for a subset of subjects from each cohort. At the GCRC visit, we willconduct an assessment of body composition, conduct testing of muscle strength and physical function,obtain blood samples for measurement of inflammatory and other markers, obtain an estimate of habitualphysical activity, and perform a cognitive function evaluation. Analyses, combining interview and home visitdata, will focus on 3 major areas - (1) describing body composition findings in the 2 cohorts, (2) estimatingthe relationship between body composition and functional limitations and disability in the 2 cohorts; and (3)identification of factors that may modify or mediate the relationship between body composition and eitherfunctional limitations or disability. Analyses will also identify the correlation between self-reported informationfrom interview data (e.g., body mass index calculated from self-reported height and weight) with thatgathered from the GCRC assessment. The findings from this study will provide information that can assist inidentifying individuals with RA and SLE who may be at greatest risk of disability, and estimating the effect ofintervening factors on the development of disability.
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