Diabetes, hyperglycemia, and the burden of functional disability among older adults in a community-based study

Job G. Godino, Lawrence J. Appel, Alden L. Gross, Jennifer A. Schrack, Christina M. Parrinello, Rita R. Kalyani, Beverly Gwen Windham, James S. Pankow, Stephen B. Kritchevsky, Karen Bandeen-Roche, Elizabeth Selvin

Research output: Contribution to journalArticle

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Abstract

Background: There is a need for continued surveillance of diabetes-related functional disability. In the present study, we examined associations between diabetes, hyperglycemia, and the burden of functional disability in a community-based population. Methods: A cross-sectional analysis was conducted of 5035 participants who attended Visit 5 (2011-13) of the Atherosclerosis Risk in Communities study. Functional disability was dichotomously defined by any self-reported difficulty performing 12 tasks essential to independent living grouped into four functional domains. Associations of diagnosed diabetes (via self-report) and undiagnosed diabetes and prediabetes (via HbA1c) with functional disability were evaluated using Poisson regression. Results: Participants had a mean age of 75years, 42 % were male, 22 % were Black, and 31 % had diagnosed diabetes. Those with diagnosed diabetes had a significantly greater burden of functional disability than those without diabetes, even after adjustment for demographics, health behaviors, and comorbidities: prevalence ratios (95 % confidence intervals) were 1.24 (1.15, 1.34) for lower extremity mobility, 1.14 (1.07, 1.21) for general physical activities, 1.33 (1.16, 1.52) for instrumental activities of daily living (ADL), and 1.46 (1.24, 1.73) for ADL (all P<0.05). The associations of undiagnosed diabetes and prediabetes with disability were not statistically significant (all P> 0.05). Conclusions: Among older adults, the burden of functional disability associated with diabetes was not entirely explained by known risk factors, including comorbidities. Hyperglycemia below the threshold for the diagnosis of diabetes was not associated with disability. Research into effective strategies for the prevention of functional disability among older adults with diabetes is needed.

Original languageEnglish (US)
JournalJournal of Diabetes
DOIs
StateAccepted/In press - 2016
Externally publishedYes

Fingerprint

Activities of Daily Living
Hyperglycemia
Comorbidity
Independent Living
Prediabetic State
Health Behavior
Self Report
Lower Extremity
Atherosclerosis
Cross-Sectional Studies
Demography
Confidence Intervals
Research
Population

Keywords

  • Aging
  • Diabetes complications
  • Disability
  • Physical function
  • Prevalence

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Godino, J. G., Appel, L. J., Gross, A. L., Schrack, J. A., Parrinello, C. M., Kalyani, R. R., ... Selvin, E. (Accepted/In press). Diabetes, hyperglycemia, and the burden of functional disability among older adults in a community-based study. Journal of Diabetes. https://doi.org/10.1111/1753-0407.12386

Diabetes, hyperglycemia, and the burden of functional disability among older adults in a community-based study. / Godino, Job G.; Appel, Lawrence J.; Gross, Alden L.; Schrack, Jennifer A.; Parrinello, Christina M.; Kalyani, Rita R.; Windham, Beverly Gwen; Pankow, James S.; Kritchevsky, Stephen B.; Bandeen-Roche, Karen; Selvin, Elizabeth.

In: Journal of Diabetes, 2016.

Research output: Contribution to journalArticle

Godino, JG, Appel, LJ, Gross, AL, Schrack, JA, Parrinello, CM, Kalyani, RR, Windham, BG, Pankow, JS, Kritchevsky, SB, Bandeen-Roche, K & Selvin, E 2016, 'Diabetes, hyperglycemia, and the burden of functional disability among older adults in a community-based study', Journal of Diabetes. https://doi.org/10.1111/1753-0407.12386
Godino, Job G. ; Appel, Lawrence J. ; Gross, Alden L. ; Schrack, Jennifer A. ; Parrinello, Christina M. ; Kalyani, Rita R. ; Windham, Beverly Gwen ; Pankow, James S. ; Kritchevsky, Stephen B. ; Bandeen-Roche, Karen ; Selvin, Elizabeth. / Diabetes, hyperglycemia, and the burden of functional disability among older adults in a community-based study. In: Journal of Diabetes. 2016.
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abstract = "Background: There is a need for continued surveillance of diabetes-related functional disability. In the present study, we examined associations between diabetes, hyperglycemia, and the burden of functional disability in a community-based population. Methods: A cross-sectional analysis was conducted of 5035 participants who attended Visit 5 (2011-13) of the Atherosclerosis Risk in Communities study. Functional disability was dichotomously defined by any self-reported difficulty performing 12 tasks essential to independent living grouped into four functional domains. Associations of diagnosed diabetes (via self-report) and undiagnosed diabetes and prediabetes (via HbA1c) with functional disability were evaluated using Poisson regression. Results: Participants had a mean age of 75years, 42 {\%} were male, 22 {\%} were Black, and 31 {\%} had diagnosed diabetes. Those with diagnosed diabetes had a significantly greater burden of functional disability than those without diabetes, even after adjustment for demographics, health behaviors, and comorbidities: prevalence ratios (95 {\%} confidence intervals) were 1.24 (1.15, 1.34) for lower extremity mobility, 1.14 (1.07, 1.21) for general physical activities, 1.33 (1.16, 1.52) for instrumental activities of daily living (ADL), and 1.46 (1.24, 1.73) for ADL (all P<0.05). The associations of undiagnosed diabetes and prediabetes with disability were not statistically significant (all P> 0.05). Conclusions: Among older adults, the burden of functional disability associated with diabetes was not entirely explained by known risk factors, including comorbidities. Hyperglycemia below the threshold for the diagnosis of diabetes was not associated with disability. Research into effective strategies for the prevention of functional disability among older adults with diabetes is needed.",
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AU - Godino, Job G.

AU - Appel, Lawrence J.

AU - Gross, Alden L.

AU - Schrack, Jennifer A.

AU - Parrinello, Christina M.

AU - Kalyani, Rita R.

AU - Windham, Beverly Gwen

AU - Pankow, James S.

AU - Kritchevsky, Stephen B.

AU - Bandeen-Roche, Karen

AU - Selvin, Elizabeth

PY - 2016

Y1 - 2016

N2 - Background: There is a need for continued surveillance of diabetes-related functional disability. In the present study, we examined associations between diabetes, hyperglycemia, and the burden of functional disability in a community-based population. Methods: A cross-sectional analysis was conducted of 5035 participants who attended Visit 5 (2011-13) of the Atherosclerosis Risk in Communities study. Functional disability was dichotomously defined by any self-reported difficulty performing 12 tasks essential to independent living grouped into four functional domains. Associations of diagnosed diabetes (via self-report) and undiagnosed diabetes and prediabetes (via HbA1c) with functional disability were evaluated using Poisson regression. Results: Participants had a mean age of 75years, 42 % were male, 22 % were Black, and 31 % had diagnosed diabetes. Those with diagnosed diabetes had a significantly greater burden of functional disability than those without diabetes, even after adjustment for demographics, health behaviors, and comorbidities: prevalence ratios (95 % confidence intervals) were 1.24 (1.15, 1.34) for lower extremity mobility, 1.14 (1.07, 1.21) for general physical activities, 1.33 (1.16, 1.52) for instrumental activities of daily living (ADL), and 1.46 (1.24, 1.73) for ADL (all P<0.05). The associations of undiagnosed diabetes and prediabetes with disability were not statistically significant (all P> 0.05). Conclusions: Among older adults, the burden of functional disability associated with diabetes was not entirely explained by known risk factors, including comorbidities. Hyperglycemia below the threshold for the diagnosis of diabetes was not associated with disability. Research into effective strategies for the prevention of functional disability among older adults with diabetes is needed.

AB - Background: There is a need for continued surveillance of diabetes-related functional disability. In the present study, we examined associations between diabetes, hyperglycemia, and the burden of functional disability in a community-based population. Methods: A cross-sectional analysis was conducted of 5035 participants who attended Visit 5 (2011-13) of the Atherosclerosis Risk in Communities study. Functional disability was dichotomously defined by any self-reported difficulty performing 12 tasks essential to independent living grouped into four functional domains. Associations of diagnosed diabetes (via self-report) and undiagnosed diabetes and prediabetes (via HbA1c) with functional disability were evaluated using Poisson regression. Results: Participants had a mean age of 75years, 42 % were male, 22 % were Black, and 31 % had diagnosed diabetes. Those with diagnosed diabetes had a significantly greater burden of functional disability than those without diabetes, even after adjustment for demographics, health behaviors, and comorbidities: prevalence ratios (95 % confidence intervals) were 1.24 (1.15, 1.34) for lower extremity mobility, 1.14 (1.07, 1.21) for general physical activities, 1.33 (1.16, 1.52) for instrumental activities of daily living (ADL), and 1.46 (1.24, 1.73) for ADL (all P<0.05). The associations of undiagnosed diabetes and prediabetes with disability were not statistically significant (all P> 0.05). Conclusions: Among older adults, the burden of functional disability associated with diabetes was not entirely explained by known risk factors, including comorbidities. Hyperglycemia below the threshold for the diagnosis of diabetes was not associated with disability. Research into effective strategies for the prevention of functional disability among older adults with diabetes is needed.

KW - Aging

KW - Diabetes complications

KW - Disability

KW - Physical function

KW - Prevalence

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