Indicators of Functional Disability by Receipt of Disability Benefits among Individuals with SLE.

Abstract

Objective: We estimated the prevalence of potential functional disability among those with systemic lupus erythematosus (SLE), by receipt of disability benefits.

Methods: Participants (N=442; mean age, 46.2; 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 NIH Toolbox Fluid Cognition score <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 at least one 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 post-estimation 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. 50.0%, 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 (43.2% vs. 22.0%, 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.