Less time spent walking and depressive symptoms are associated with more self-perceived disability in primary care patients: a cross-sectional study from Uganda

Abstract

Introduction: evidence on associations between self-perceived disability and physical activity levels in primary care patients (PCP) in low-income countries is absent. We investigated whether self-perceived disability is associated with physical activity levels while taking into account relevant demographic, social, mental and health parameters and other lifestyle factors in PCP in Uganda.

Methods: in this cross-sectional study, patients from two primary care centers in a farming community in central Uganda completed the World Health Organization Disability Assessment Schedule 2 (WHODAS 2), Simple Physical Activity Questionnaire (SIMPAQ), Patient Health Questionnaire-9 (PHQ-9), Alcohol Use Disorders Identification Test, and Multidimensional Scale for Perceived Social Support. Somatic co-morbidity and multimorbidity were self-reported or retrieved from medical files. A backward linear regression was performed in order to explain the variance in WHODAS 2 total scores.

Results: in 130 PCP [median (interquartile range) age=47.0 (22.0); 73.1% (n=95) female], older age, less time spent walking (SIMPAQ) and more severe depressive symptoms (PHQ-9) were independent significant predictors of more self-perceived disability (WHODAS 2). The final model explained 44.2% of the variance in WDODAS 2 scores.

Conclusion: our study demonstrates that self-perceived disability in PCP living in low-resourced settings is associated with older age, physical inactivity and depressive symptoms. Future lifestyle studies in primary care settings should consider targeting both physical and mental health outcomes in order to reduce self-perceived disability in PCP, in particular in older patients.