The British Journal of Rheumatology, Vol 37, 1069-1076, Copyright © 1998 by British Society for Rheumatology
E Thomas, EM Hay, A Hajeer and AJ Silman
OBJECTIVE: Using the European Community (EC) criteria for classification
Vitali et al. Arthritis Rheum 1993;36:340 7, we report the prevalence
estimates of Sjogren's syndrome (SS) from a general population and present
the first population data to assess the impact of the syndrome. METHODS: A
cross-sectional population-based survey performed on 1000 adults, aged
18-75 yr, randomly selected from a population register. Responders to the
initial postal phase were invited for an interview. The five criteria
measured at interview were: (1) the reporting of subjective oral symptoms
lasting for > 3 months; (2) the reporting of subjective ocular symptoms
lasting for >3 months; (3) Schirmer-I test; (4) unstimulated salivary
flow; (5) autoantibodies [Ro (SS-A), La (SS-B), rheumatoid factor (RF),
antinuclear antibodies (ANA)]. SS was diagnosed if at least four of these
five criteria were positive. The MOS Short-form 36 (SF-36), General Health
Questionnaire (GHQ) and the Health and Fatigue Questionnaire (HFQ) were
completed by subjects after the interview, and scores were compared between
those with and without a diagnosis of SS. RESULTS: A total of 341 subjects
completed both the postal questionnaire and home visit. A diagnosis of SS
could be given to 13 subjects. After adjusting for the presence of possible
bias due to non-response, our best estimate of the prevalence of SS in the
study population was 33 per 1000 subjects (95% CI 22 44). The prevalence of
the disorder was higher in females (38; 95% CI 27-52) and for those
subjects aged > or = 55 yr (46; 95% CI 34-61). Those subjects diagnosed
positively were more impaired for each of the eight dimensions of the SF-36
than those without a diagnosis, and also suffered from higher levels of
depression and fatigue. CONCLUSIONS: SS affects approximately 3-4% of
adults and in the general population appears to be associated with a
clinically significant impairment of a subject's health and well-being.
ORIGINAL PAPERS
Sjogren's syndrome: a community-based study of prevalence and impact
ARC Epidemiology Research Unit, University of Manchester.
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