Abstract
This study investigated how physical functioning and perceived disability are related to depressive symptoms in adults with arthritis (n = 401). Participants self-reported depressive symptoms and disability. Objective measures of physical functioning included the 30-second chair stand test, 6-minute walk test, gait speed, balance, grip strength, and the seated reach test. Separate quantile regression models tested associations between each functional measure and depressive symptoms, controlling for age, gender, race, BMI, self-reported health status, and arthritis medication use. The association between perceived disability and depressive symptoms was also tested. Participants averaged 56.3 ± 10.7 years; 85.8% were women; 64.3% were white. Lower distance in the 6-minute walk test, fewer chair stands, slower gait speed, and greater perceived disability were associated with greater depressive symptoms in unadjusted models (Ps < 0.05). Fewer chair stands and greater perceived disability were associated with more depressive symptoms in adjusted models (Ps < 0.05). Balance, grip strength, and seated reach were not related to depressive symptoms. The perception of being disabled was more strongly associated with depressive symptoms than reduced physical functioning. To reduce the risk of depression in arthritic populations, it may be critical to not only address physical symptoms but also to emphasize coping skills and arthritis self-efficacy.
Highlights
For public health purposes, the term arthritis refers to over 100 musculoskeletal conditions of varying etiologies that cause pain, aching, or stiffness in or around a joint [1]
This paper examined depressive symptoms in relation to both objective physical functioning and perceived disability in a diverse sample of adults with arthritis
Lower distance walked in the 6-minute walk test (P = 0.004), fewer chair stands (P < 0.001), slower gait speed (P = 0.004), and greater perceived disability were associated with greater depressive symptoms
Summary
The term arthritis refers to over 100 musculoskeletal conditions of varying etiologies that cause pain, aching, or stiffness in or around a joint [1]. During 2007–2009, an estimated 50 million adults in the United States reported doctor-diagnosed arthritis [2]. When rising obesity rates are considered, an even larger public health burden can be expected, as obesity has been associated with both the development and progression of arthritis [4]. A recent study estimates that 18% of adults with arthritis have comorbid depression [5], compared with 7% of the general US population [6]. This high prevalence may be due, in part, to the functional limitations associated with arthritis symptoms. Depression may be linked to perceived disability, a construct closely related to functional limitation, but with an important distinction: functional limitations alone, defined as alterations in the performance of a functional task, are not the equivalent of disability, defined as the inability of an individual to perform his or her social and environmental roles [7]
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