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 language | English (US) |
|---|---|
| Journal | Journal of Diabetes |
| DOIs | |
| State | Accepted/In press - 2016 |
| Externally published | Yes |
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Keywords
- Aging
- Diabetes complications
- Disability
- Physical function
- Prevalence
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
Cite this
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 journal › Article
}
TY - JOUR
T1 - Diabetes, hyperglycemia, and the burden of functional disability among older adults in a community-based study
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
UR - http://www.scopus.com/inward/record.url?scp=84961798851&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84961798851&partnerID=8YFLogxK
U2 - 10.1111/1753-0407.12386
DO - 10.1111/1753-0407.12386
M3 - Article
AN - SCOPUS:84961798851
JO - Journal of Diabetes
JF - Journal of Diabetes
SN - 1753-0393
ER -