Factors related to fatigue in women and men with early rheumatoid arthritis: the Swedish TIRA study

J Rehabil Med. 2009 Nov;41(11):904-12. doi: 10.2340/16501977-0444.


Objective: To study whether there are differences between women and men with regard to the reported level of fatigue, to explore the strength of the relations between fatigue and disease activity, pain, sleep disturbance, mental health, and activity limitation in early rheumatoid arthritis, and to explore the consistency of such findings.

Design: Analyses and comparisons of cross-sectional data.

Subjects: Two hundred and seventy-six patients, 191 women and 85 men, with early rheumatoid arthritis were included.

Methods: Patients were examined with respect to 28-joint count disease activity score, and disability variables reflecting pain, sleep disturbance, fatigue, mental health, and activity limitation, at follow-ups at 1, 2 and 3 years after diagnosis.

Results: Women reported somewhat more fatigue than men. Fatigue was closely and rather consistently related to disease activity, pain and activity limitation, and also to mental health and sleep disturbance.

Conclusion: Although this study does not permit conclusions to be drawn about causal directions, statistical relationships may be related to clinical conceptions about causation: when disease activity can be significantly reduced by pharmacological treatment this may have a positive effect on fatigue. Specific treatment with respect to the mentioned disability aspects that are related to fatigue is also a clinically reasonable strategy.

MeSH terms

  • Activities of Daily Living
  • Arthritis, Rheumatoid / complications*
  • Arthritis, Rheumatoid / physiopathology
  • Arthritis, Rheumatoid / psychology
  • Cross-Sectional Studies
  • Disability Evaluation
  • Fatigue / etiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mental Health
  • Middle Aged
  • Pain Measurement
  • Sex Factors
  • Sleep Wake Disorders / complications
  • Sleep Wake Disorders / etiology