Pathways To Pain And Disability: The Impact of Early Social Deprivation And Educational Attainment In Newly Diagnosed Osteoarthritis Patients

Abstract

Previous research established links between pain and cognitive function on one hand and pain and anxiety on the other, and there is some evidence linking osteoarthritis to lower educational attainment. However, the inter-play of these factors and the role of key social factors (social deprivation) at the early disease stages are not understood. Using data from waves 4, 5, 6 and 7 of the Survey of Health, Ageing and Retirement in Europe (SHARE) (n = 1,240), we tested how social deprivation, education and anxiety, before diagnosis, affects the relationship between cognitive function, pain and independence (activities of daily living) in a subsample of respondents reporting a diagnosis of osteoarthritis at wave 6, with cross-lagged panel models. We show that social deprivation, before osteoarthritis diagnosis, predicts functional impairment in daily living after diagnosis, with this effect partly mediated by impaired cognitive function, and that education before diagnosis is protective against impairments in daily living after diagnosis via better cognitive function and lower anxiety at wave 5. Therefore, improving cognitive function and managing anxiety may mitigate the negative impact of social deprivation and low educational attainment on independent living and help to promote independence in patients with osteoarthritis.