|
 |
|
|||||||
|
|||||||||
© 2005 by the American Diabetes Association, Inc.
Pathophysiology/Complications |
Longitudinal Predictors of Reduced Mobility and Physical Disability in Patients With Type 2 Diabetes
The Fremantle Diabetes Study
School of Medicine and Pharmacology, Fremantle Hospital, University of Western Australia, Fremantle, Western Australia, Australia
Address correspondence and reprint requests to Associate Professor David Bruce, University of Western Australia, School of Medicine and Pharmacology, Fremantle Hospital, P.O. Box 480, Fremantle, WA 6959, Australia. E-mail: dbruce{at}cyllene.uwa.edu.au
OBJECTIVE—The purpose of this study was to determine longitudinal predictors of impaired mobility and physical disability in patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—We studied patients with type 2 diabetes who participated in a prospective, community-based study. A wide range of baseline variables were examined to determine whether they predicted future difficulties with 1) mobility and 2) basic activities of daily living (ADLs) in patients free of ADLs difficulty at baseline. To study mobility impairment, subjects with baseline mobility problems were also excluded.
RESULTS—After an average 4.6 ± 2.3 and 4.8 ± 2.3 years of follow-up in 818 and 934 patients, respectively, 28.5% of subjects had developed new mobility impairment and 18.1% had developed new ADL disability. In Cox proportional hazards models, the risk of mobility impairment was significantly increased by older age (6%/year), peripheral neuropathy (40% increase), stroke history (123%), insulin treatment (117%), albuminuria, and arthritis (82%); taking exercise and being married lowered the risk (by 39 and 32%, respectively). The risk of new ADL disability was increased by baseline mobility problems (222% increase), stroke (92%), claudication (67%), and depression (41%) and was also influenced by age, smoking, lack of exercise, nonfluency in English, and indigenous Australian ethnicity.
CONCLUSIONS—Both mobility impairment and ADL disability in type 2 diabetes have multiple causes that are due to diabetes complications and common comorbidities. The specific causes of each functional problem are largely distinct, and different approaches may be required to prevent their onset or progression.
Abbreviations: ADL, activity of daily living • CHD, coronary heart disease • CVD, cerebrovascular disease • FDS, Fremantle Diabetes Study • GHS, General Health Status
CiteULike 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
|
|
 |
|
  J. E. Schillerstrom, D. R. Royall, and R. F. Palmer Depression, Disability and Intermediate Pathways: A Review of Longitudinal Studies in Elders J Geriatr Psychiatry Neurol, September 1, 2008; 21(3): 183 - 197. [Abstract] [PDF]
|
|
|
|
 |
|
 S. Bossoni, G. Mazziotti, C. Gazzaruso, D. Martinelli, S. Orini, S. B. Solerte, G. Romanelli, and A. Giustina Relationship between instrumental activities of daily living and blood glucose control in elderly subjects with type 2 diabetes Age Ageing, March 1, 2008; 37(2): 222 - 225. [Full Text] [PDF]
|
|
|
|
 |
|
 R. Orr, T. Tsang, P. Lam, E. Comino, and M. F. Singh Mobility Impairment in Type 2 Diabetes: Association with muscle power and effect of Tai Chi intervention. Diabetes Care, September 1, 2006; 29(9): 2120 - 2122. [Full Text] [PDF]
|
|
|
|
 |
|
 Mobility Limitation Among Persons Aged >=40 Years With and Without Diagnosed Diabetes and Lower Extremity Disease--United States, 1999-2002 JAMA, January 4, 2006; 295(1): 29 - 30. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Diabetes | Diabetes Care | Clinical Diabetes | Diabetes Spectrum |