Background/Purpose: Older women with osteoarthritis (OA) often report difficulty with tasks and needing to rely on others for assistance. In addition, depressed mood has been observed among individuals with arthritis. However, there is little research examining relationship physical disability and the perception of dependence with depression among women with arthritis. This study assessed whether both physical disability and perceived dependence relate to depression or whether perceived dependence in personal care activities, household activities, community mobility and valued activities is an intermediate step in the relationship between physical disability and depressive symptoms.

Methods: Data come from a cross-sectional survey of 209 women, aged 55 or older, with osteoarthritis (OA). Physical disabilities were examined in four domains: personal care, household activities, community mobility and valued activities. Perceived dependence was asked in each domain using the question ‘Thinking about these activities, to what extent do you feel dependent?’. Responses were on a 5-point scale from 0 = ‘not at all’ to 4 = ‘a great deal’. Depression was assessed using the Center for Epidemiological Studies – Depression Scale (CES-D). Mediation analyses occurred in four step and included regression analyses as outlined by Baron and Kenny.

Results: On average, participants reported mild or moderate disability and perceived dependence. 28.7 % of participants reported a depression score ≥ 16, which indicates  depressive symptomotology. The results from step 1 show that, greater difficulty with each domain of physical disabilities was significantly related to greater perceived dependence. In step 2, greater perceived dependence was significantly associated with greater depressive symptoms in all domains. Step 3 analyses showed that greater physical disabilities in each domain were significantly associated with depression. The final step testing mediation indicated that personal care activities, household activities and community mobility were fully mediated by perceived dependence. That is, once dependence was taken into account, the relationship between physical disabilities and depression was no longer significant. Partial mediation was found for dependence and valued activity limitations. Both were significantly related to depression.

Conclusion: It is important to take into account the experience of perceived dependence as a mediator in understanding the relationship between disability and depression in the domains of personal care, household, and community mobility.  However, for valued activities, both disability and perceived dependence are important in understanding depression. This may be because valued activities are discretionary and reflect a person’s identity (i.e., what’s important to them). Also, they are not always activities where others can provide assistance, making perceptions of dependence less relevant. To conclude, these findings point to the importance of taking into account an individual’s reaction to their disability rather than just focusing on the severity of disability

ACR Meeting Abstracts - https://acrabstracts.org/abstract/physical-disability-perceived-dependence-and-depression-in-older-women-with-osteoarthriti/