Sexual orientation and functional limitations: cross-sectional analyses from the Adult Psychiatric Morbidity Survey

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Jacob, L., López-Sánchez, G.F., Kostev, K., Schnitzler, A., Haro, J.M., Koyanagi, A., McDermott, D.T. ORCID: 0000-0001-7005-6446, Shin, J.I. and Smith, L., 2021. Sexual orientation and functional limitations: cross-sectional analyses from the Adult Psychiatric Morbidity Survey. Archives of Physical Medicine and Rehabilitation. ISSN 0003-9993

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Official URL: https://doi.org/10.1016/j.apmr.2021.04.005

Abstract

Objective: To assess the association between sexual orientation and functional limitations in a large representative sample of the English population.

Design: Cross-sectional.

Setting: Data were from the 2007 Adult Psychiatric Morbidity Survey (APMS).

Participants: 7,403 adults aged 16-95 years (51.4% females, mean [standard deviation] age 46.3 [18.6] years) were included in the present study.

Interventions: Not applicable.

Main Outcome Measures: Sexual orientation was assessed using two items adapted from the Kinsey scale, and was dichotomized into heterosexual and sexual minority orientation. Functional limitations were assessed using seven activities of daily living (ADL) and instrumental activities of daily living (IADL). Functional limitations were defined as at least one difficulty in one of seven ADL and IADL. Adjusted logistic regression analyses were conducted to investigate the association between sexual orientation (independent variable) and functional limitations (dependent variable).

Results: The level of sexual minority orientation and prevalence of functional limitations in the sample was 7.1% and 32.9%, respectively. After adjusting for several potential confounders, sexual minority orientation was positively and significantly associated with functional limitations (OR = 1.51, 95% CI: 1.18-1.95; reference group: heterosexual orientation).

Conclusions: Based on the findings of this study, interventions aiming to prevent against and/or manage/reduce functional limitations in sexual minorities are needed. More research is also warranted to better understand mediators (e.g., obesity, cognitive complaints, and psychiatric disorders) involved in the sexual orientation-functional limitation relationship.