Associations of Arthritis with Functional Disability and Depressive Symptom in general US Adults: NHANES 1988-1994 and 1999-2018

Abstract

Background Arthritis is a common chronic disease, leading to poor quality of life, which has received increasing attention. This study aimed to examine the associations of arthritis with functional disability and depressive symptom among the general US adults. Methods Participants were from the National Health and Nutrition Examination Survey (NHANES) 1988–1994 and 1999–2018. Arthritis was self-reported or graded by the Kellgren-Lawrence score after an objective X-ray examination. Functional disability included disability in activities of daily living (ADL disability), instrumental activities of daily living (IADL disability) and mobility disability. Depressive symptom was assessed using the Patient Health Questionnaire (PHQ). Multivariable logistic regression models were used to examine the associations. Results We included 22,566 older adults (≥ 60 years; 10,961 had self-reported arthritis) for functional disability analysis (2,377 older adults with data on X-ray examination; 1,012 had radiographic knee osteoarthritis) and 32,056 adults (≥ 20 years; 9,175 had self-reported arthritis) for depressive symptom analysis. After controlling for all covariates, self-reported arthritis was associated with ADL disability (odds ratios [OR]: 2.68; 95% confidence interval [CI]: 2.50–2.87), IADL disability (OR: 2.06; 95% CI: 1.94–2.20) and mobility disability (OR: 2.95; 95% CI: 2.78–3.14), and depressive symptom (OR: 2.18; 95% CI: 1.98–2.40). In participants with data on X-ray examination, radiographic knee osteoarthritis was only associated with mobility disability (OR: 1.44; 95% CI: 1.18–1.74). Conclusions Arthritis was associated with functional disability and depressive symptom in general US adults. Appropriate managements of physical and mental health are needed for those with arthritis, to improve their quality of life.