OBJECTIVES: Literature data suggest that individuals consider moderate health problems as acceptable beyond a certain age. However, little is known about the age-related acceptability of non-perfect health in chronic diseases. We aimed to assess the age-related acceptability of health problems among the general population and match the results to the health status of patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), systemic sclerosis (SSc) and osteoporosis (OP).

METHODS: A cross-sectional online survey was performed in a convenience sample. Participants were asked to indicate which level of health problem they considered to be acceptable from ages 30, 40, 50, 60, 70 and 80 years and onwards, or ‘Never’ on the five domains of the EQ-5D-3L descriptive system. EQ-5D-3L index scores (UK tariffs) were computed for each age by aggregating the single responses obtained on the 5 domains and acceptable health curve (AHC) was drawn. EQ-5D-3L index scores of patients from four previous cross-sectional surveys were matched to the AHC.

RESULTS: Altogether 9,281 individuals (males 67.2%) completed the acceptability survey with mean (SD) age of 36.0 (10.6) years, their EQ-5D-3L index score was 0.852 (0.177). Acceptable EQ-5D-3L index scores for ages from 30 to 80 were mean 0.97, 0.94, 0.89, 0.77, 0.52 and 0.10, respectively. Median EQ-5D-3L index score of patients with RA (N=248) PsA (N=177), SSc (N=80) and OP (N=207) was 0.477, 0.587, 0.620 and 0.656, respectively, and 88.3%, 87.6%, 87.5% and 50.2% of the patients were under the AHC. Severe problems levels were considered as never acceptable by the majority (52.9%-70.9%) of the public, however these occured up to 21.4% among the patients.

CONCLUSIONS: Our study provides age-specific reference points for health and highlights the burden of chronic musculoskeletal diseases from the societal perspective. These findings may have implications for health economic evaluations and decision making in healthcare.