Prevalence and correlates of restricted community mobility in a population-based cohort of adults with systemic lupus erythematosus

TL;DR

This study found that over 40% of adults with lupus have limited community mobility, with race, education, and disease activity being key factors.

Contribution

The study identifies sociodemographic and clinical factors linked to restricted community mobility in a population-based SLE cohort.

Findings

41.6% of participants had restricted community mobility.

Black race, lower education, and higher disease activity were associated with restricted mobility.

Age, sex, and disease damage did not significantly affect mobility.

Abstract

Restrictions in community mobility, defined as the frequency of and help required to travel to ‘life-spaces’ (bedroom, home, yard, neighbourhood and town), are associated with poor outcomes among older adults. We aimed to describe and explore factors associated with community mobility among adults with SLE.

We assessed community mobility cross-sectionally in a population-based SLE cohort (October 2019 to May 2022), using the University of Alabama Birmingham Study of Aging Life-Space Assessment (UAB LSA) (score range, 0–120; higher scores=greater community mobility). Community mobility was considered to be restricted if the individual reported not reaching the neighbourhood life-space or beyond at least weekly and without help. Estimated percentages (95% CIs) with restricted community mobility were assessed with multivariable logistic regression adjusting for demographics and disease activity and damage.

Among 447 participants (91.7% women; 82.6% Black; mean age 46.2; mean UAB LSA score 53.6), 41.6% had restricted community mobility. After adjustment, Black versus White race (43.4% (95% CI 38.5% to 48.2%) vs 24.4% (12.7% to 36.2%)), lowest versus highest educational attainment (51.1% (41.4% to 60.7%) vs 27.2% (20.7% to 33.6%)) and higher versus lower disease activity (55.2% (48.4% to 62.0%) vs 28.5% (22.9% to 34.3%)) were associated with a higher prevalence of restricted community mobility; there were no differences by age, sex or disease damage.

Restricted community mobility was common among adults with SLE, and Black race, lower education and high disease activity were associated with more restricted community mobility. Further research to understand the association of community mobility with outcomes and implement strategies to improve community mobility in people with SLE is warranted.

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