Indicators of Functional Disability by Receipt of Disability Benefits Among Individuals With Systemic Lupus Erythematosus.

OBJECTIVE: We estimated the prevalence of potential functional disability among those with systemic lupus erythematosus (SLE), by receipt of disability benefits. METHODS: Participants (N = 443, mean age 46.2 years, 91.7% women, 82.6% Black) were recruited from a population-based SLE cohort. Indicators of potential disability included functioning impairments (Short Physical Performance Battery score ≤ 10; age-corrected National Institutes of Health Toolbox Cognition Battery composite score for fluid cognition < 77.5 [1.5 SD below the mean]); activity limitations (physical functioning T-scores < 35 [1.5 SD below the mean]); at least some difficulty performing ≥ 1 of the instrumental activities of daily living (IADLs) or basic activities of daily living (BADLs); and participation restrictions (any vs no reported effect of health on ability to work; restricted community mobility). We performed multivariable logistic regression models predicting potential disability indicators by self-reported receipt of disability benefits and then obtained adjusted prevalence estimates using postestimation margins. RESULTS: Those who reported receiving disability benefits (45.6%) vs not (54.4%) were more likely to have impairments in functioning (physical performance [71.3% vs 50%, P < 0.001]; fluid cognition [35.4% vs 19.2%, P = 0.01]), limitations in activities (self-reported physical limitations [26.7% vs 7.5%, P < 0.001]; IADLs [73.1% vs 42.9%, P < 0.001]; BADLs [60.6% vs 30.8%, P < 0.001]), and restrictions in participation (work [77.8% vs 60.6%, P = 0.09]; community mobility [43.1% vs 22%, P < 0.001]). These associations were not changed with adjustment for personal and SLE factors. CONCLUSION: Receipt of disability benefits may be an incomplete marker of functioning. A substantial proportion of those not receiving benefits have impairments, limitations, and restrictions that should be addressed.

Duke Scholars

Author Christopher Barrett Bowling Medicine, Geriatrics and Palliative Care