Physical Function Limitations Among Middle-aged and Older Adults With Prediabetes

One exercise prescription may not fit all

  1. William H. Herman, MD, MPH1
  1. 1Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
  2. 2Veterans Affairs Ann Arbor Healthcare System, Geriatrics Research, Education and Clinical Center, Ann Arbor, Michigan
  3. 3Department of Family Medicine, University of Michigan, Ann Arbor, Michigan
  4. 4Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan
  5. 5Department of Internal Medicine, New York University, New York, New York
  1. Corresponding author: Pearl G. Lee, pearllee{at}


OBJECTIVE To describe the prevalence of physical function limitations among a nationally representative sample of adults with prediabetes.

RESEARCH DESIGN AND METHODS We performed a cross-sectional analysis of 5,991 respondents ≥53 years of age from the 2006 wave of the Health and Retirement Study. All respondents self-reported physical function limitations and comorbidities (chronic diseases and geriatric conditions). Respondents with prediabetes reported no diabetes and had a measured glycosylated hemoglobin (HbA1c) of 5.7–6.4%. Descriptive analyses and logistic regressions were used to compare respondents with prediabetes versus diabetes (diabetes history or HbA1c ≥6.5%) or normoglycemia (no diabetes history and HbA1c <5.7%).

RESULTS Twenty-eight percent of respondents ≥53 years of age had prediabetes; 32% had mobility limitations (walking several blocks and/or climbing a flight of stairs); 56% had lower-extremity limitations (getting up from a chair and/or stooping, kneeling, or crouching); and 33% had upper-extremity limitations (pushing or pulling heavy objects and/or lifting >10 lb). Respondents with diabetes had the highest prevalence of comorbidities and physical function limitations, followed by those with prediabetes, and then normoglycemia (P < 0.05). Compared with respondents with normoglycemia, respondents with prediabetes had a higher odds of having functional limitations that affected mobility (odds ratio [OR], 1.48), the lower extremities (1.35), and the upper extremities (1.37) (all P < 0.01). The higher odds of having lower-extremity limitations remained after adjusting for age, sex, and body mass index (1.21, P < 0.05).

CONCLUSIONS Comorbidities and physical function limitations are prevalent among middle-aged and older adults with prediabetes. Effective lifestyle interventions to prevent diabetes must accommodate physical function limitations.

  • Received February 20, 2013.
  • Accepted April 11, 2013.

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