Diabetes as a Predictor of Change in Functional Status Among Older Mexican Americans

Abstract

OBJECTIVE -Epidemiological studies have demonstrated that older Mexican Americans are at high risk for type 2 diabetes and its complications. Type 2 diabetes leads to a more rapid decline in functional status among older Mexican Americans with diabetes. This study was designed to examine the impact of diabetes on change in self-reported functional status over a 2-year period among older Mexican Americans with diabetes. RESEARCH DESIGN AND METHODS -We performed a longitudinal analysis with repeated measurements of functional limitations in a cohort of Mexican Americans aged Ն60 years in the Sacramento Area Latino Study on Aging (SALSA). Diabetes was diagnosed on the basis of self-report of physician diagnosis, medication use, and fasting plasma glucose. Functional status was measured by assessment of activities of daily living (ADL) and instrumental activities of daily living (IADL) at baseline and 1 and 2 years.RESULTS -Of 1,789 SALSA participants, 585 (33%) had diabetes at baseline. Diabetic subjects reported 74% more limitations than nondiabetic subjects in ADL (summary score for number of limitations, 0.99 vs. 0.57; P ϭ 0.002) and 50% more limitations in IADL (summary score for number of limitations, 7.83 vs. 5.25; P Ͻ 0.0001). The annual rate of increase in limitations of ADL and IADL was 0.046 and 0.033 (log scale) on each scale among diabetic subjects compared with 0.013 and 0.003 (log scale) among nondiabetic subjects (P Ͻ 0.0005). Complications of diabetes were found to increase ADL and IADL limitations among diabetic subjects. Longer duration of diabetes was also associated with an increase in ADL and IADL limitations.

Gender Differences in Functional Limitations in Adults Living with Type 2 Diabetes: Biobehavioral and Psychosocial Mediators

“…Over the past decade, there has been increasing focus on the influence of diabetes on functional limitations in middle-aged and older adults [1][2][3][4][5][6][7][8][9][10][11][12][13]. Although findings from these studies were not consistent in reporting which aspects of physical function were most affected by diabetessome studies report that diabetes was associated with increased rates of functional declines in instrumental activities of daily living, strength, and mobility, but not with activities of daily living [12], whereas others have found the strong link between diabetes and limitations in activities of daily living [6,11]-these studies have generally shown that diabetes confers a markedly increased risk of functional limitations in middle-aged and older adults.…”

Frailty and Hormones

“…Numerous studies have found that persons with diabetes mellitus have greater functional decline than other older persons [59][60][61][62][63][64]. Persons with diabetes are much less likely to read, garden, use the telephone, write letters or go out socially [65].…”

Evaluation of Cognitive Functions and Daily Living Activities of Elderly Diabetics under Intensive Insulin Therapy

“…On querying about the expectations of the elderly with type II diabetes, the answer obtained was that the patients wanted to primarily and independently fulfill the ADL (26). Wu et al (27) compared the performance of ADL in healthy individuals with that of the diabetics and found that more than 74% of the diabetics had a disability in performing the basic ADL, and that more than 50% had a disability in performing the instrumental ADL. In a study conducted in the United States, it was indicated that 79.1% elderly were found to be independent in the ADL.…”