Indicators of Functional Disability by Receipt of Disability Benefits Among Individuals With Systemic Lupus Erythematosus

Objective We estimated the prevalence of potential functional disability among those with systemic lupus erythematosus (SLE), by receipt of disability benefits.

Methods Participants (N = 443, mean age 46.2 years, 91.7% women, 82.6% Black) were recruited from a population-based SLE cohort. Indicators of potential disability included functioning impairments (Short Physical Performance Battery score ≤ 10; age-corrected National Institutes of Health Toolbox Cognition Battery composite score for fluid cognition < 77.5 [1.5 SD below the mean]); activity limitations (physical functioning T-scores < 35 [1.5 SD below the mean]); at least some difficulty performing ≥ 1 of the instrumental activities of daily living (IADLs) or basic activities of daily living (BADLs); and participation restrictions (any vs no reported effect of health on ability to work; restricted community mobility). We performed multivariable logistic regression models predicting potential disability indicators by self-reported receipt of disability benefits and then obtained adjusted prevalence estimates using postestimation margins.

Results Those who reported receiving disability benefits (45.6%) vs not (54.4%) were more likely to have impairments in functioning (physical performance [71.3% vs 50%, P < 0.001]; fluid cognition [35.4% vs 19.2%, P = 0.01]), limitations in activities (self-reported physical limitations [26.7% vs 7.5%, P < 0.001]; IADLs [73.1% vs 42.9%, P < 0.001]; BADLs [60.6% vs 30.8%, P < 0.001]), and restrictions in participation (work [77.8% vs 60.6%, P = 0.09]; community mobility [43.1% vs 22%, P < 0.001]). These associations were not changed with adjustment for personal and SLE factors.

Conclusion Receipt of disability benefits may be an incomplete marker of functioning. A substantial proportion of those not receiving benefits have impairments, limitations, and restrictions that should be addressed.