Sexual Orientation and Functional Limitations: Cross-sectional Analyses From the Adult Psychiatric Morbidity Survey

Arch Phys Med Rehabil. 2021 Nov;102(11):2117-2124. doi: 10.1016/j.apmr.2021.04.005. Epub 2021 May 4.

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.

Participants: A total of 7403 adults aged 16-95 years (51.4% female; mean age, 46.3±18.6y) were included in the present study.

Interventions: Not applicable.

Main outcome measures: Sexual orientation was assessed using 2 items adapted from the Kinsey scale and was dichotomized into heterosexual and sexual minority orientation. Functional limitations were assessed using 7 activities of daily living (ADL) and instrumental activities of daily living (IADL). Functional limitations were defined as at least 1 difficulty in 1 of 7 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 (odds ratio, 1.51; 95% confidence interval, 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 (eg, obesity, cognitive complaints, psychiatric disorders) involved in the sexual orientation-functional limitation relationship.

Keywords: Activities of daily living; Cross-sectional study; Disabled persons; Rehabilitation; Sexual behavior; United Kingdom.

MeSH terms

  • Activities of Daily Living*
  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Cross-Sectional Studies
  • Disabled Persons / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Physical Therapy Modalities / standards*
  • Sex Factors
  • Sexual and Gender Minorities / statistics & numerical data*
  • Sexuality / statistics & numerical data*
  • Socioeconomic Factors
  • Young Adult