A biopsychosocial approach to understanding the impact of osteoarthritis on social participation: a population-based study

While the definition of healthy aging across studies is variable, the focus is dominated by disability in activities of daily living; this is especially true in osteoarthritis (OA) research. However, older individuals identify healthy/successful aging more so with social participation and engagement than with activity limitations and disease. OA is a leading cause of pain and activity limitations, which are among the strongest predictors of social participation. The prevalence of OA increases significantly as people age, and because our population is aging, OA poses a significant threat to social participation. Yet, there has been little work that has examined social participation in OA in the population. This proposal investigates the relationship between OA and social participation in a large population-based and representative Canadian sample. Our goal is to understand the relationship of OA to pain, in turn to activity and mobility, and ultimately to social participation.

For this project, we analytically decomposed the association between osteoarthritis and social participation considering activity limitations, perceived instrumental support, and received instrumental support (intervening variables). Two distinct social participation indicators were identified. Without considering intervening variables, minimal/no association was found between osteoarthritis and social participation. When considered, unique pathways linking osteoarthritis and social participation were found. The overall negative association between activity limitations and social participation was, in part, direct and, in part, buffered by both receipt and perceived availability of instrumental supports. Absent activity limitations, osteoarthritis was associated with greater social participation. For those with activity limitations, findings highlight the need for interventions to mitigate limitations and draw particular attention to the importance of both provision and awareness of available instrumental support in maintaining social support.