Abstract / Summary
IntroductionRheumatoid arthritis (RA) patients have increased disability risk, with physical inactivity and socioeconomic factors that are contributing to worse outcomes. Limited data exist on these relationships in Middle Eastern and Arab populations, and validated predictive models are scarce in the literature. Our study aims to assess physical activity levels and evaluate health-related quality of life and disability findings in RA patients from Riyadh, Saudi Arabia, and develop a sociodemographic risk-stratification model to quantify disability risk based on our cohort.MethodsWe collected our data for the study from RA patients in Riyadh, Saudi Arabia, through a disseminated cross-section survey for the eligible targeted cohort. Physical activity was assessed using IPAQ-S, disability using HAQ-DI, and sociodemographic characteristics through structured interviews. We developed a sociodemographic risk-stratification model using multiple linear regression with interaction terms, validated through 10-fold cross-validation and bootstrap methods (1,000 iterations). Mediation analysis was performed to investigate education-employment-disability pathways. Risk stratification algorithms and utilization assessments were performed.ResultsPhysical inactivity was highly prevalent, with the majority of included individuals reporting low physical activity levels. Mean HAQ-DI was 0.58 (SD 0.55). The model achieved a cross-validated R2 of 0.188 (mean per-fold test R2 = 0.122), reflecting the modest explanatory ceiling expected when only sociodemographic predictors are modeled, while still stratifying patients into low (58.2%), moderate (28.2%), and high (13.7%) disability risk categories. Education showed the strongest association with disability (ε2 = 0.093, P < 0.0001), with employment partially mediating this relationship (13.4% mediation, 95% CI: 7.5–20.1%). Model calibration was significant, with utilization probability demonstrated across risk thresholds.ConclusionWe developed the first structured analysis for RA disability prediction in the region, revealing complete physical inactivity and significant socioeconomic disparities. Our analyses findings demonstrated evidence-based risk stratification for further consideration while identifying modifiable intervention targets. The results support population-level physical activity interventions and targeted socioeconomic support programs.