Physical activity, pain, and iron burden as independent correlates of quality of life in adults with beta-thalassemia major in the United Arab Emirates.
Aljawarneh Y, Kurian A, Musallam L • Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation • 2026
Physical activity and pain are important correlates of specific dimensions of quality of life in adults with beta-thalassemia major, whereas serum ferritin does not appear to be directly associated with patient-reported QoL.
Key Findings
Results
Physical activity category was independently associated with physical and social quality of life domains after multivariable adjustment.
250 adults with transfusion-dependent beta-thalassemia major were enrolled from a specialized treatment center in the UAE
Mean participant age was 31.7 ± 7.8 years
45.6% of participants reported low physical activity levels
Physical activity was assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF)
Adjustments were made for age, gender, employment status, chelator use, transfusion/chelation frequency, pain intensity, and serum ferritin
Results
Participants with high physical activity had significantly higher psychological quality of life compared to those with low physical activity.
The overall physical activity factor was not significantly associated with psychological QoL as a whole
However, the specific comparison between high and low physical activity groups reached statistical significance (p = 0.040) for psychological QoL
QoL was measured using the WHOQOL-BREF, which assesses physical, psychological, social, and environmental domains
Results
Pain intensity was independently associated with lower physical, psychological, and environmental quality of life, but not social quality of life.
59.2% of participants reported thalassemia-related pain
Pain intensity was measured using a Numeric Rating Scale (NRS)
Pain was independently associated with lower physical, psychological, and environmental QoL domains (all p ≤ 0.003)
The association between pain intensity and social QoL domain was not statistically significant
Results
Serum ferritin was not independently associated with any quality of life domain or pain intensity after multivariable adjustment.
Serum ferritin values were extracted from medical records as an objective measure of iron burden
Serum ferritin was included as a covariate in multivariable general linear models
No significant association was found between serum ferritin and any of the four WHOQOL-BREF domain scores after adjustment
Serum ferritin also showed no significant independent association with pain intensity after adjustment
Methods
The study enrolled 250 adults with transfusion-dependent beta-thalassemia major using a cross-sectional design at a specialized treatment center in the UAE.
Cross-sectional study design was used
All 250 eligible participants were included in the analyses
Participants completed the IPAQ-Short Form, the WHOQOL-BREF, and a Numeric Rating Scale for pain
Multivariable general linear models were conducted to evaluate associations with all four WHOQOL-BREF domain scores
What This Means
This research looked at how physical activity levels, iron overload (measured by serum ferritin), and pain relate to quality of life in 250 adults living with beta-thalassemia major (a serious inherited blood disorder requiring regular blood transfusions) in the United Arab Emirates. The researchers found that nearly half of participants had low physical activity levels, and almost 60% experienced thalassemia-related pain. Using statistical models that accounted for multiple factors simultaneously, they found that being more physically active was linked to better physical and social well-being, and those with high physical activity also reported better psychological well-being compared to those with low activity.
The study also found that pain was a significant factor independently linked to worse physical, psychological, and environmental quality of life, but not social quality of life. Interestingly, the level of iron buildup in the body — commonly monitored in thalassemia patients as a key medical concern — was not directly linked to how patients rated their own quality of life or pain after accounting for other factors. This suggests that while managing iron overload remains medically important, it may not be the primary driver of how patients feel about their day-to-day lives.
This research suggests that for adults living with beta-thalassemia major, supporting physical activity and addressing pain may be just as important for overall well-being as the standard biomedical treatments focused on transfusions and iron management. Healthcare providers caring for this population might consider incorporating physical activity promotion and pain management strategies alongside traditional medical care to improve patients' lived experience of the disease.
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Aljawarneh Y, Kurian A, Musallam L. (2026). Physical activity, pain, and iron burden as independent correlates of quality of life in adults with beta-thalassemia major in the United Arab Emirates.. Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation. https://doi.org/10.1007/s11136-026-04372-z