Study Finds Increased Impaired Mobility by Sex, Age in Atopic Dermatitis

Patients with atopic dermatitis (AD) who are male and those aged 40 to 59 years may have more impaired mobility, according to a study published in the Journal of Clinical and Aesthetic Dermatology.¹

AD affects a patient’s quality of life beyond the immediate symptoms of pruritus and rash, as it also significantly impacts his or her psychological and physical well-being; this often leads to various detrimental effects on daily activities.² More specifically, past studies have found that physical capabilities, like exercise intensity, are diminished among patients with AD.^3,4

However, the researchers of the present study noted that the impact of AD on other physical capability metrics, like baseline mobility, has yet to be fully investigated¹; they defined baseline mobility as “the standard level of functional ambulation or movement capability.” They attempted to bridge this knowledge gap by analyzing the relationship between AD and mobility among US adults aged 20 to 59 years.

To create their study population, the researchers used data from the National Health and Nutrition Examination Survey (NHANES). More specifically, they synthesized data across 3 consecutive 2-year cycles of the NHANES database, spanning 2001 to 2006; this allowed them to construct a robust sample size, which enhanced the reliability of their findings.

To assess baseline mobility among the population, the researchers used mobility metrics through self-reported walking difficulties. Through a survey, they asked patients to reflect on their physical capabilities. The researchers considered patients to have impaired mobility if they responded affirmatively to this question: “Because of a health problem, do you have difficulty walking without using any special equipment?”

Also, they analyzed the relationship between AD and impaired mobility by applying multivariable logistic regression analyses. The researchers controlled for age, education, income, race, sex, tobacco use, body mass index, and diabetes.

Initially, the study population consisted of 10,088 patients. However, the researchers excluded 3548 of these patients because they did not respond to questions assessing impaired mobility and AD; the final study population consisted of 6540 patients.

Of the study population, 608 patients were diagnosed with AD, and 5932 did not have AD. The prevalence of impaired mobility was 7.1% weighted among those with AD and 3.9% weighted among those without AD. After adjusting for potential confounding variables, the researchers found a significant association between AD and impaired mobility among patients aged 20 to 59 years (adjusted OR [aOR], 1.65; 95% CI, 1.19-3.25; P = .010).

Also, through subgroup analyses, they determined that male patients with AD (aOR, 2.55; 95% CI, 1.21-5.40; P = .016) and adults aged 40 to 59 years (aOR, 1.94; 95% CI, 1.03-3.68; P = .042) had significantly increased odds of impaired mobility.

“Older adults with AD may experience increased rates of impaired mobility due to age-related changes in skin barrier function and immune response, both of which deteriorate naturally with age and are further impacted by AD-related pathophysiological changes,” the authors wrote.

The researchers acknowledged their limitations, one being the potential for self-reporting bias; this is because the survey was directed toward patients, not their health care providers. Also, the age in the study population was limited since the oldest patients with recorded AD in the NHANES database during the specified timeframe were 59 years old. Despite these limitations, the researchers suggested areas for future research based on their findings.

“The introduction of our study outlines the substantial burden that AD can impose on an individual’s daily function,” the authors wrote. “Research in populations without AD indicates that impaired mobility is associated with decreased quality of life due to the functional limitations it imposes. There is a need for additional research to determine whether similar correlations exist for AD patients with mobility impairments.”

References

1. Osborne S, Kam O, Vo C, Wescott R, Thacker S, Wu JJ. Association between atopic dermatitis and impaired mobility among adults in the United States: findings from the 2001-2006 National Health and Nutrition Examination survey. J Clin Aesthet Dermatol. 2024;17(6):58-60.

2. Gochnauer H, Valdes-Rodriguez R, Cardwell L, Anolik RB. The psychosocial impact of atopic dermatitis. Adv Exp Med Biol. 2017;1027:57-69. doi:10.1007/978-3-319-64804-0_6

3. Silverberg JI, Song J, Pinto D, et al. Atopic dermatitis is associated with less physical activity in US adults. J Invest Dermatol. 2016;136(8):1714-1716. doi:10.1016/j.jid.2016.04.025

4. Schwartzman G, Lei D, Ahmed A, Chavda R, Gabriel S, Silverberg JI. Association of adult atopic dermatitis severity with decreased physical activity: a cross-sectional study. Dermatitis. 2023;34(3):218-223. doi:10.1097/DER.0000000000000921