Physical Function Limitations Among Middle-aged and Older Adults With Prediabetes
One exercise prescription may not fit all
- Pearl G. Lee, MD1,2⇑,
- Christine T. Cigolle, MD, MPH1,2,3,
- Jinkyung Ha, PHD1,
- Lillian Min, MD, MSHS1,2,
- Susan L. Murphy, SCD, OTR/L2,4,
- Caroline S. Blaum, MD5 and
- William H. Herman, MD, MPH1
- 1Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
- 2Veterans Affairs Ann Arbor Healthcare System, Geriatrics Research, Education and Clinical Center, Ann Arbor, Michigan
- 3Department of Family Medicine, University of Michigan, Ann Arbor, Michigan
- 4Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan
- 5Department of Internal Medicine, New York University, New York, New York
- Corresponding author: Pearl G. Lee, .
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.
- © 2013 by the American Diabetes Association.
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