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Impact of Diabetes on Physical Function in Older People

¹ University of Bedfordshire, Luton, U.K
² Nottingham University, Nottingham, U.K
³ Cardiff University, Cardiff, U.K

Address correspondence and reprint requests to Alan Sinclair, Professor of Medicine, Bedfordshire and Hertfordshire Postgraduate Medical School, University of Bedfordshire, Putteridge Bury campus, Hitchin Road, Luton, LU2 8LE, U.K. E-mail: sinclair0.5{at}btinternet.com

OBJECTIVE—To explore the nature of functional impairment in older people with diabetes.

RESEARCH DESIGN AND METHODS—A population-based case-control study with detailed assessment of diabetes and functional status was undertaken.

RESULTS—Altogether, 403 case subjects and 403 matched control subjects were studied (median age 75 years, 51% female). Subjects with diabetes had more comorbidities than control subjects (mean 2.5 vs. 1.9, P < 0.0001) and were more likely to have severe functional impairment (4 vs. 1%, Barthel score <5, P < 0.001). Health status pertaining to physical function was reduced in case subjects (SF36 60 vs. 40, P < 0.0001). In a multivariate model controlling for age, hypertension, cerebrovascular disease, chronic obstructive pulmonary disease, cancer, osteoarthritis, and dementia, diabetes remained significantly associated with mobility limitation (odds ratio 2.1, P < 0.001).

CONCLUSIONS—Older people with diabetes have considerable functional impairment associated with reduced health status. This population may benefit from comprehensive geriatric assessment and tailored diabetes management.

Abbreviations: COPD, chronic obstructive pulmonary disease • IQR, interquartile range

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