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

TitleDiabetes, hyperglycemia, and the burden of functional disability among older adults in a community-based study
Publication TypeJournal Article
Year of Publication2017
AuthorsGodino, JG, Appel, LJ, Gross, AL, Schrack, JA, Parrinello, CM, Kalyani, RR, Windham, BG, Pankow, JS, Kritchevsky, SB, Bandeen-Roche, K, Selvin, E
JournalJ Diabetes
Date PublishedFeb 5
ISBN Number1753-0407 (Electronic)1753-0407 (Linking)
Accession Number26847713
KeywordsAging, diabetes complications, Disability, Physical function, Prevalence

BACKGROUND: There is a need for continued surveillance of diabetes-related functional disability. We examined associations between diabetes, hyperglycemia, and the burden of functional disability in a community-based population. METHODS: We conducted a cross-sectional analysis of 5,035 participants who attended visit 5 (2011-2013) 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. We evaluated associations of diagnosed diabetes (via self-report), and undiagnosed diabetes and prediabetes (via HbA1c ), with functional disability using Poisson regression. RESULTS: Participants had a mean age of 75 years, 42% were male, 22% were black, and 31% had diagnosed diabetes. Those with diagnosed diabetes had a significantly greater burden of functional disability compared to those without diabetes even after adjustment for demographics, health behaviors, and comorbidities: prevalence ratios (95% CIs) 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; and 1.46 (1.24, 1.73) for activities of daily living (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.