Activity limitation, chronic disease, and comorbid serious psychological distress in U.S. adults--BRFSS 2007.
OBJECTIVE
This study examines the prevalence of self-reported activity limitation from poor physical or mental health in the past 30 days among a sample of noninstitutionalized U.S. adults. The associations between frequent activity limitation, chronic diseases, and comorbid serious psychological distress (SPD) were also examined.


METHODS
2007 Behavioral Risk Factor Surveillance System (BRFSS) data were used to generate prevalence estimates of days of self-reported activity limitation in the past 30 days (i. e., 0 days, 1-13 days, 14-29 days, 30 days, and 14 or more days) by selected sociodemographic characteristics, chronic disease conditions (i. e., lifetime diagnosis of diabetes, hypertension, coronary heart disease, stroke, asthma), and comorbid serious psychological distress. Multivariate logistic regression analysis was used to generate adjusted odds ratios of frequent activity limitation (14-30 days in the past 30 days) among persons with selected chronic disease conditions and among those with comorbid serious psychological distress.


RESULTS
A total of 21 % of adults reported activity limitation for at least 1 day in the past 30 days; 6.6 % reported 14 or more days, and 3.4 % reported all 30 days. Comorbid serious psychological distress was significantly associated with reported frequent activity limitation among persons who also reported a lifetime diagnosis of selected chronic diseases. Furthermore, in multivariate models adjusted for sociodemographic variables and the presence of the other chronic conditions, adults with comorbid lifetime diagnosis of a selected chronic disease and serious psychological distress were significantly more likely to report 14 or more days of activity limitation than those with only a lifetime diagnosis of a chronic condition.


CONCLUSIONS
Physicians should proactively screen and effectively treat co-occurring mental conditions in patients with chronic diseases who report frequent days of activity limitation because serious psychological distress may contribute to their level of impairment.
McKnight-Eily
Lela R
LR
Division of Adult and Community Health, Centers for Disease Control and Prevention, 4770 Buford Highway N.E., Atlanta, GA 30341-3717, USA. LMcKnightEily@cdc.gov
Elam-Evans
Laurie D
LD
Strine
Tara W
TW
Zack
Matthew M
MM
Perry
Geraldine S
GS
Presley-Cantrell
Letitia
L
Edwards
Valerie J
VJ
Croft
Janet B
JB
D000203:Activities of Daily Living / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D002908:Chronic Disease / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D015995:Prevalence; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D014481:United States / Q000453:epidemiology; D055815:Young Adult