This study investigated how physical functioning and perceived disability are related to depressive symptoms in adults with arthritis ( ). 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 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 ( ). Fewer chair stands and greater perceived disability were associated with more depressive symptoms in adjusted models ( ). 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. 1. Introduction 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]. During 2007–2009, an estimated 50 million adults in the United States reported doctor-diagnosed arthritis [2]. As the US population grows in number and the baby boomers continue to enter older adulthood, arthritis is projected to affect 67 million Americans by 2030 [3]. When rising obesity rates are also 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 also 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 also 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
References
[1]
J. M. Hootman, C. G. Helmick, and T. J. Brady, “A public health approach to addressing arthritis in older adults: the most common cause of disability,” The American Journal of Public Health, vol. 102, no. 3, pp. 426–433, 2012.
[2]
Y. J. Cheng, J. M. Hootman, L. B. Murphy, G. A. Langmaid, and C. G. Helmick, “Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation-United States, 2007–2009,” Morbidity and Mortality Weekly Report, vol. 59, no. 39, pp. 1261–1265, 2010.
[3]
J. M. Hootman and C. G. Helmick, “Projections of US prevalence of arthritis and associated activity limitations,” Arthritis and Rheumatism, vol. 54, no. 1, pp. 226–229, 2006.
[4]
A. Anandacoomarasamy, I. Caterson, P. Sambrook, M. Fransen, and L. March, “The impact of obesity on the musculoskeletal system,” International Journal of Obesity, vol. 32, no. 2, pp. 211–222, 2008.
[5]
L. B. Murphy, J. J. Sacks, T. J. Brady, J. M. Hootman, and D. P. Chapman, “Anxiety and depression among US adults with arthritis: prevalence and correlates,” Arthritis Care and Research, vol. 64, no. 7, pp. 968–976, 2012.
[6]
W. C. Reeves, T. W. Strine, L. A. Pratt et al., “Mental illness surveillance among adults in the United States,” Morbidity and Mortality Weekly Report, vol. 60, supplement 3, pp. 1–29, 2011.
[7]
S. Nagi, “Some conceptual issues in disability and rehabilitation,” in Sociology and Rehabilitation, M. Sussman, Ed., p. 100, American Sociological Society, Washington, DC, USA, 1965.
[8]
Centers for Disease Control and Prevention, Behavior Risk Factor Surveillance System, 2011.
[9]
R. Adams, “Revised physical activity readiness questionnaire,” Canadian Family Physician, vol. 45, pp. 992–1005, 1999.
[10]
L. S. Radloff, “The CES-D scale : a self report depression scale for research in general population,” Applied Psychological Measurements, vol. 1, pp. 385–401, 1977.
[11]
E. M. Andresen, J. A. Malmgren, W. B. Carter, and D. L. Patrick, “Screening for depression in well older adults: evaluation of a short form of the CES-D,” The American Journal of Preventive Medicine, vol. 10, no. 2, pp. 77–84, 1994.
[12]
R. W. Bohannon and K. L. Schaubert, “Test-retest reliability of grip-strength measures obtained over a 12-week interval from community-dwelling elders,” Journal of Hand Therapy, vol. 18, no. 4, pp. 426–428, 2005.
[13]
C. J. Jones, R. E. Rikli, and W. C. Beam, “A 30-s chair-stand test as a measure of lower body strength in community-residing older adults,” Research Quarterly for Exercise and Sport, vol. 70, no. 2, pp. 113–119, 1999.
[14]
K. A. Lemmink, H. C. Kemper, M. H. de Greef, P. Rispens, and M. Stevens, “The validity of the sit-and-reach test and the modified sit-and-reach test in middle-aged to older men and women,” Research Quarterly for Exercise and Sport, vol. 74, no. 3, pp. 331–336, 2003.
[15]
B. A. Pankoff, T. J. Overend, S. Deborah Lucy, and K. P. White, “Reliability of the six-minute walk test in people with fibromyalgia,” Arthritis Care and Research, vol. 13, no. 5, pp. 291–295, 2000.
[16]
B. Pankoff, T. Overend, D. Lucy, and K. White, “Validity and responsiveness of the 6 minute walk test for people with fibromyalgia,” Journal of Rheumatology, vol. 27, no. 11, pp. 2666–2670, 2000.
[17]
K. E. Webster, J. E. Wittwer, and J. A. Feller, “Validity of the GAITRite？ walkway system for the measurement of averaged and individual step parameters of gait,” Gait and Posture, vol. 22, no. 4, pp. 317–321, 2005.
[18]
B. Bilney, M. Morris, and K. Webster, “Concurrent related validity of the GAITRite？ walkway system for quantification of the spatial and temporal parameters of gait,” Gait and Posture, vol. 17, no. 1, pp. 68–74, 2003.
[19]
C. Bauer, I. Gr？ger, R. Rupprecht, and K. G. Ga？mann, “Intrasession reliability of force platform parameters in community-dwelling older adults,” Archives of Physical Medicine and Rehabilitation, vol. 89, no. 10, pp. 1977–1982, 2008.
[20]
B. Bruce and J. F. Fries, “The health assessment questionnaire (HAQ),” Clinical and Experimental Rheumatology, vol. 23, supplement 39, no. 5, pp. S14–S18, 2005.
[21]
D. D. Dunlop, J. S. Lyons, L. M. Manheim, J. Song, and R. W. Chang, “Arthritis and heart disease as risk factors for major depression the role of functional limitation,” Medical Care, vol. 42, no. 6, pp. 502–511, 2004.
[22]
M. A. Whooley, “Depression and cardiovascular disease: healing the broken-hearted,” Journal of the American Medical Association, vol. 295, no. 24, pp. 2874–2881, 2006.
[23]
M. Pinquart and P. R. Duberstein, “Depression and cancer mortality: a meta-analysis,” Psychological Medicine, vol. 40, no. 11, pp. 1797–1810, 2010.
[24]
X. Zhang, S. L. Norris, E. W. Gregg, Y. J. Cheng, G. Beckles, and H. S. Kahn, “Depressive symptoms and mortality among persons with and without diabetes,” The American Journal of Epidemiology, vol. 161, no. 7, pp. 652–660, 2005.
[25]
C. J. Jones, D. N. Rutledge, and J. Aquino, “Predictors of physical performance and functional ability in people 50+ with and without fibromyalgia,” Journal of Aging and Physical Activity, vol. 18, no. 3, pp. 353–368, 2010.
[26]
J. F. Bean, D. D. ？lveczky, D. K. Kiely, S. I. LaRose, and A. M. Jette, “Performance-based versus patient-reported physical function: what are the underlying predictors?” Physical Therapy, vol. 91, no. 12, pp. 1804–1811, 2011.
[27]
M. Shih, J. M. Hootman, T. W. Strine, D. P. Chapman, and T. J. Brady, “Serious psychological distress in U.S. adults with arthritis,” Journal of General Internal Medicine, vol. 21, no. 11, pp. 1160–1166, 2006.
[28]
J. Ormel, F. V. Rijsdijk, M. Sullivan, E. van Sonderen, and G. I. J. Kempen, “Temporal and reciprocal relationship between IADL/ADL disability and depressive symptoms in late life,” Journals of Gerontology B, vol. 57, no. 4, pp. P338–P347, 2002.
[29]
E. H. B. Lin, W. Katon, M. von Korff et al., “Effect of improving depression care on pain and functional outcomes among older adults with arthritis: a randomized controlled trial,” Journal of the American Medical Association, vol. 290, no. 18, pp. 2428–2434, 2003.
[30]
“Physical activity guidelines advisory committee report, 2008. To the secretary of health and human services. Part A: executive summary,” Nutrition Reviews, vol. 67, no. 32, pp. 114–120, 2009.
[31]
J. Barlow, A. Turner, L. Swaby, M. Gilchrist, C. Wright, and M. Doherty, “An 8-yr follow-up of arthritis self-management programme participants,” Rheumatology, vol. 48, no. 2, pp. 128–133, 2009.
