Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Lower socioeconomic status (SES) has been shown to be associated with poor physical functioning in systemic lupus erythematosus (SLE) patients; however, previous studies have not used poverty income ratio (PIR), which measures poverty as a ratio of household income to appropriate poverty threshold for household size, as a proxy for SES in this population. Thus, we examined the association of PIR with self-reported physical functioning in a cohort of SLE patients and also whether this association was similar for self-reported physical functioning and a set of complementary measures of physical functioning.
Methods: We used cross-sectional data on 744 participants from the ongoing Georgians Organized Against Lupus (GOAL) cohort, and secondary analyses used data on 56 participants from a GOAL-ancillary pilot study. Primary analyses utilized multivariable linear regression to estimate the association between PIR (categorized as <1.00 (income below the poverty threshold), 1.00-1.99, 2.00-3.99, and ≥4.00 (income 4 times the poverty threshold)) and physical functioning (PF; scaled subscore from Short Form-12 survey; range, 0-100, with higher scores indicating better functioning). Secondary analyses summarized complementary measures of physical functioning as means or percentages by PIR (categorized as <1.00, 1.00-1.99, and ≥2.00).
Results: Overall, the mean age of participants was 48.0 years; 6.7% were male; 80.9% were black; and 37.5%, 21.0%, 29.6% and 12.0% had PIRs of <1.00, 1.00-1.99, 2.00-3.99, and ≥4.00, respectively. The overall mean PF score was 45.8 (36.2, 40.7, 55.5, and 61.2 for PIRs of <1.00, 1.00-1.99, 2.00-3.99, and ≥4.00, respectively). With adjustment, higher PIRs (<1.00, 2.00-3.99, and ≥4.00, respectively, vs. 1.00-1.99) remained associated (β [95% CI]) with higher PF scores (-6.0 [-12.8 to 0.8], 10.9 [3.3 to 18.6], and 16.2 [6.4 to 26.0]). In secondary analyses, higher PIR was consistently associated with better physical functioning across domains, in that participants with higher PIRs, on average, had higher scores for measures of physical performance, were less likely to report difficulty with activities of daily living, and had fewer falls in the prior year. For example, mean Short Physical Performance Battery scores (range, 0-12) were better in those with PIR ≥2.00 compared to those with PIR <1.00 and 1.00-1.99 (10.2 vs. 8.4 and 8.2).
Conclusion: Our results show that higher SES is associated with better physical functioning across multiple domains, warranting further research into multi-component functional assessments to develop individual treatment plans and potentially improve disparities in SLE outcomes.
To cite this abstract in AMA style:Hoge C, Bowling CB, Lim SS, Drenkard C, Plantinga L. Association of Poverty Income Ratio with Physical Functioning in a Cohort of Patients with Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/association-of-poverty-income-ratio-with-physical-functioning-in-a-cohort-of-patients-with-systemic-lupus-erythematosus/. Accessed April 8, 2020.
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