Background/Purpose:  Depression is one of the most common mental disorders in the United States, affecting 15.7 million adults. It frequently co-occurs with other chronic conditions (e.g., arthritis), particularly in middle age and older adults. Despite the considerable evidence that physical activity reduces symptoms and adverse effects of arthritis and depression, physical inactivity is highly prevalent among those with these conditions. The study purpose was to estimate the 2013 prevalence of: 1) arthritis among adults with self-reported depression; 2) physical inactivity among adults with depression by arthritis status.

Methods:   The Behavioral Risk Factor Surveillance System (BRFSS) is an annual state-based random-digit dialed telephone survey of the civilian, noninstitutionalized US population aged >18 years. Doctor-diagnosed arthritis was defined as a ‘yes’ to: “Have you ever been told by a doctor or other health care professional that you have arthritis, rheumatoid arthritis, gout, lupus or fibromyalgia?” Self-reported depression was defined as a ‘yes’ to: “Ever told you have a depressive disorder, including depression, major depression, dysthymia, or minor depression?” Physical activity level was assessed using 6 questions on frequency and duration of participation in activities of moderate and vigorous intensity. Persons reporting no participation in either moderate or vigorous physical activity were classified as physically inactive. The 2013 BRFSS (n= 491,773) weighted median response and cooperation rates were 45.9% and 65.7%, respectively. Calculation of percentages and 95% confidence intervals (CI) accounted for the NHIS’ multistage, complex sample design. Percentages were age-standardized using the 2000 US projected adult population provided by the US National Center for Health Statistics.

Results:   In 2013, 42.8% (95% CI=42.2-43.5; 18.5 million) of US adults with self-reported depression also had arthritis. Compared to adults with neither condition (25.9%; CI=25.6-26.3), adults with depression only (35.9%; CI=35.2-36.5), arthritis only (35.3%; CI=34.5-36.2), and both depression and arthritis (41.6%; CI=40.3-42.9) had significantly higher prevalence of physical inactivity (Figure).

Conclusion:   Depression and arthritis frequently co-occur and the combination is associated with high prevalence of physical inactivity, a missed opportunity to engage in a proven non-pharmaceutical self-management strategy for both conditions. Through universal screening of patients with arthritis for depression, health care providers may identify a treatable barrier to increasing physical activity.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/arthritis-as-a-potential-barrier-to-physical-activity-among-adults-with-depression-united-states-behavioral-risk-factor-surveillance-system-2013/