Limitations in Activities of Daily Living Among Individuals With Systemic Lupus Erythematosus

We aimed to estimate the burden and identify potential correlates of limitations in activities of daily living (ADLs) among persons with systemic lupus erythematosus (SLE).

Individuals with SLE were recruited from a population-based cohort (October 2019 to May 2022) and reported their ability to independently perform various instrumental ADLs (IADLs) and basic ADLs (BADLs) via survey. Limitations were defined as having at least some difficulty performing at least one of the IADLs or BADLs. Descriptive statistics were calculated, and associations (adjusted odds ratios [aORs]) of various participant characteristics with IADL and BADL limitations were assessed with logistic regression adjusting for age, sex, and race.

The mean age of the 436 participants was 46.2 years; most were female (91.7%) and Black (82.8%). More than half (56.2%) reported limitations in IADLs, most commonly housekeeping (50.7%), laundry (37.2%), and shopping (33.0%); 43.8% reported limitations in independently performing BADLs, most commonly transferring (26.6%), bathing (25.3%), dressing (24.4%), and continence (22.0%). Higher disease activity (greater than or equal to vs less than the median) was strongly associated with IADLs (aOR 6.49, 95% confidence interval [CI] 4.15-10.2) and BADLs (aOR 7.35, 95% CI 4.70-11.5), along with higher depression and perceived stress scores, lower educational attainment and income, and older age.

IADL and BADL limitations may be common in individuals with SLE and more prevalent among those who report higher disease activity, depressive symptoms, and lower income and among those who are older. Research to support evidence-based strategies for improvement in quality of life and maintenance of independence in the older SLE population is warranted.