Anthony V Perruccio1,2,3,4, Calvin Yip1,2,5, J Denise Power1, Mayilee Canizares1, Monique Am Gignac1,2,5,6, Elizabeth M Badley1,2,5. 1. Healthcare & Outcomes Research and Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Canada. 2. Arthritis Community Research and Evaluation Unit, Toronto, Canada. 3. Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health. 4. Department of Surgery, University of Toronto, Toronto, Canada, Ontario. 5. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada, Ontario. 6. Institute for Work and Health, Toronto, Canada, Ontario.
Abstract
OBJECTIVE: The focus on disability in osteoarthritis (OA) has largely been on performing specific activities, neglecting wider implications for social participation (SP). We investigated the association between OA and SP considering activity limitations (AL) and instrumental supports (IS) as intervening variables in the association. METHODS: Data were from 21,214 respondents aged 45-85 from cycle 1, Canadian Longitudinal Study on Aging. The questionnaire elicited: self-reported doctor-diagnosed OA; difficulty with 14 activities; perceived availability and receipt of IS; and 17 SP activities. Structural equation modeling was used. PRIMARY OUTCOME: SP; Primary predictor: OA; Intervening variables: AL, received IS, perceived IS. Latent variables were developed for intervening and SP variables. Covariates: age, sex, body mass index, income, education, smoking, comorbidity count. RESULTS: Mean age was 63 years, 51% were female, and 26.5% reported OA. Two distinct SP indicators were identified, SP-Diversity and SP-Intensity. Without considering intervening variables, minimal/no association was found between OA and SP. When considered, unique pathways linking OA and SP were found. The overall negative association between AL and SP was, in part, direct and, in part, buffered by both receipt and perceived availability of IS. Absent AL, OA was associated with greater SP. CONCLUSIONS: Enhanced SP in people with OA without AL may reflect proactive steps taken by those with mild OA to maintain activity and social engagement. For those with AL, findings highlight the need for interventions to mitigate limitations and draw particular attention to the importance of both provision and awareness of available IS in maintaining SP. This article is protected by copyright. All rights reserved.
OBJECTIVE: The focus on disability in osteoarthritis (OA) has largely been on performing specific activities, neglecting wider implications for social participation (SP). We investigated the association between OA and SP considering activity limitations (AL) and instrumental supports (IS) as intervening variables in the association. METHODS: Data were from 21,214 respondents aged 45-85 from cycle 1, Canadian Longitudinal Study on Aging. The questionnaire elicited: self-reported doctor-diagnosed OA; difficulty with 14 activities; perceived availability and receipt of IS; and 17 SP activities. Structural equation modeling was used. PRIMARY OUTCOME: SP; Primary predictor: OA; Intervening variables: AL, received IS, perceived IS. Latent variables were developed for intervening and SP variables. Covariates: age, sex, body mass index, income, education, smoking, comorbidity count. RESULTS: Mean age was 63 years, 51% were female, and 26.5% reported OA. Two distinct SP indicators were identified, SP-Diversity and SP-Intensity. Without considering intervening variables, minimal/no association was found between OA and SP. When considered, unique pathways linking OA and SP were found. The overall negative association between AL and SP was, in part, direct and, in part, buffered by both receipt and perceived availability of IS. Absent AL, OA was associated with greater SP. CONCLUSIONS: Enhanced SP in people with OA without AL may reflect proactive steps taken by those with mild OA to maintain activity and social engagement. For those with AL, findings highlight the need for interventions to mitigate limitations and draw particular attention to the importance of both provision and awareness of available IS in maintaining SP. This article is protected by copyright. All rights reserved.
Entities:
Keywords:
CLSA; activity limitations; instrumental support; osteoarthritis; social participation