Disability, reduced social participation associated with chronic conditions in middle-age

Middle-age adults living with a combination of arthritis, heart disease or diabetes, and depression are more likely to experience disability and limited involvement in society, new research from McMaster University has found.

The study, published in the Journal of Epidemiology and Community Health, found that physical and mental chronic conditions, alone and in combination, were strongly associated with disability and social participation restrictions. However, the impact of these combinations of conditions differed by gender and age.

The research was led by Lauren Griffith, an associate professor in the Department of Clinical Epidemiology and Biostatics and the holder of the McLaughlin Foundation Professorship in Population and Public Health.

"These findings help us to better understand, at a population level, the biggest drivers of disability for middle-aged and older adults," said Griffith. "What this research shows is that depending on your age and sex, the specific chronic diseases most highly associated with disability in the population differ."

The study found:

• Arthritis was consistently associated with disability for men and women across most age groups
• In middle-aged adults (45-54 years), depression and arthritis were most often associated with disability and social participation restrictions, especially in women.
• Compared to women, combinations of chronic conditions that included diabetes and heart disease were stronger drivers of disability in men, especially in the younger age group (45-54 years).

To conduct the study, the research team analyzed population-based data from more than 15,000 participants in the Canadian Community Health Survey on Healthy Aging. The survey, which was conducted between 2008 and 2009, gathered information from adults aged 45 to 85 years old who were not institutionalized and living in one of 10 Canadian provinces.

While the association between single chronic conditions and disability is well documented, there is little research examining the combination of both physical and mental chronic conditions on disability and social participation.

The researchers concluded that knowing which chronic conditions are associated with greater disability and social participation limitations may help clinicians to target treatment strategies for patients. Similarly, for policy-makers, this information may help in the development of preventative health strategies for individual conditions, as well as clusters of diseases.

"Oftentimes, when we are looking at disability, especially for chronic conditions, we are looking at the 65 and older age group," Griffith said. "But if we want to be able to develop interventions earlier to help prevent or slow down the progression of disability, we need to start looking at the impact of chronic conditions on younger age groups."