Age, Education Level Can Affect One’s Ability to Cope with AS, Study Finds

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by Alice Melao |

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Progressing disease, older age, and lower education can significantly affect ankylosing spondylitis patients’ ability to cope with the challenges and burden associated with their illness, a study has found.

Multidisciplinary clinical teams should take these findings into consideration to prevent additional health problems and provide the best care and support to those with a chronic rheumatic disease, researchers suggest.

The study, “Evaluation of coping with chronic rheumatic disease, in the context of socio-demographic factors and disease duration, based on the example of patients with ankylosing spondylitis,” was published in the journal Reumatologia.

Chronic rheumatic diseases are often associated with high burden, not only for patients but also for their families.

Such diseases, including ankylosing spondylitis, are commonly progressive and can severely affect the patient’s quality of life and the ability to interact with others and the environment. This highlights the need to better understand which factors could have an impact on a patient’s overall outcome.

Polish researchers conducted a study aiming to identify sociodemographic and disease duration factors that could affect the ability of ankylosing spondylitis patients to cope with their illness.

The study enrolled 82 patients with medically confirmed ankylosing spondylitis, 89% of whom were males. They were asked to respond to three questionnaires that allowed researchers to assess their psychological status (whether they were depressed), how well they were accepting their illness, and overall sense of coherence.

Sense of coherence can be defined as an internal and central factor that allows people to cope with stress and their health status, based on their ability to adapt. It relies on three main components: sense of comprehensibility — how someone perceives incoming information; sense of manageability — one’s ability to recognize and use resources to fulfill their needs; and sense of meaningfulness — a person’s capacity to see meaning in life and willingness to deal with problems.

In general, patients reported to have accepted their illness, according to a mean Acceptance of Illness Scale score of 26.9 for the all group. Still, 47 participants (57.3%) showed signs of moderate to severe depression, while 35 (42.7%) were not depressed or had low mood.

A detailed analysis of several sociodemographic variables revealed that patients who had higher education were more likely to accept their disease, not be depressed, and have a higher sense of coherence. In contrast, older patients who were retired were found to struggle more to accept their illness and were at higher risk of depression.

Patients who had suffered from ankylosing spondylitis for more than 20 years had bigger problems with illness acceptance. Also, they were found to be at risk of depression and to have more difficulties maintaining their inner balance (coherence).

“Younger respondents showed better perception of reality, belief in coping with new situations, difficulties, and problem-solving efforts compared to the older patients,” researchers said.

Overall, these findings suggest that patients with ankylosing spondylitis who have a low sense of coherence also have less capacity to adapt to the illness and have a greater risk of developing depressive disorders.

“Sociodemographic factors such as older age and lower education should be taken into consideration” in therapeutic interventions to help those with ankylosing spondylitis cope, researchers suggested. These factors are mainly “associated with lower coherence, poorer acceptance of the disease, and a greater risk of depression,” they stated.