Comorbidities and impairments explaining the association between diabetes and lower extremity disability - The Women's Health and Aging Study
Comorbidities and impairments explaining the association between diabetes and lower extremity disability - The Women's Health and Aging Study
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DOI：
10.2337/diacare.25.4.678
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发表时间：
2002-04-01
期刊：
影响因子：
16.2
通讯作者：
Guralnik, JM
中科院分区：
文献类型：
--
作者：
Volpato, S;Blaum, C;Guralnik, JM
目的：为了阐明糖尿病相关损害和合并症在糖尿病和肢体残疾之间的关系，本研究以残疾老年妇女为样本，研究了糖尿病和肢体功能之间的关系。研究设计和方法：横断面分析1,002名妇女(年龄2：65岁)参加妇女健康和老龄化研究(占所有社区居住人口中残疾程度最高的三分之一)。糖尿病和其他医疗状况是通过使用多种信息来源的标准标准来确定的。结果：糖尿病女性明显更容易发生心血管疾病、周围神经功能障碍、视力障碍、肥胖和抑郁，在调整年龄后，糖尿病女性有更高的行动能力障碍(优势比[OR]1.85，95%CI 1.12-3.06)、日常生活能力障碍(1.61，1.06-2.43)和严重行走受限(2.34，1.56-3.50)，以及她们的综合活动能力评分(基于平衡、步态速度、椅子站立)比非糖尿病女性低1.4分(P<；0.001)。外周动脉疾病、周围神经功能障碍和抑郁是主要的个体致病因素；然而，这些疾病本身都不能完全解释糖尿病和残疾之间的联系。相反，只有在对所有潜在的调节因素进行调整后，糖尿病和残疾之间的关系才能在很大程度上减少，结论--即使在身体受损的老年妇女中，糖尿病也与残疾的主要负担有关。广泛的损害和并存解释了糖尿病和残疾的关系，这表明这种联系的机制是多因素的。
OBJECTIVE - To elucidate the role of diabetes-related impairments and comorbidities in the association between diabetes and physical disability, this study examined the association between diabetes and lower extremity function in a sample of disabled older women.RESEARCH DESIGN AND METHODS - Cross-sectional analysis of 1,002 women (aged 2:65 years) enrolled in the Women's Health and Aging Study (one-third most disabled of the total community-dwelling population). Diabetes and other medical conditions were ascertained by standard criteria that used Multiple sources of information. Functional status was assessed using self-reported and objective performance measures,RESULTS - Women with diabetes were significantly more likely to have cardiovascular diseases, peripheral nerve dysfunction, visual impairment, obesity, and depression, After adjustment for age, women with diabetes had a greater prevalence of mobility disability (odds ratio [OR] 1.85, 95% Cl 1.12-3.06), activities of daily living disability (1.61, 1.06-2.43), and severe walking limitation (2.34, 1.56-3.50), and their summary mobility performance score (0-12 scale based on balance, gait speed, chair stands) was 1.4 points lower than in nondiabetic women (P < 0.001). Peripheral artery disease, peripheral nerve dysfunction, and depression were the main individual contributing factors; however, none of these conditions alone fully explained the association between diabetes and disability. Conversely, only after adjusting for all potential mediators,vas the relationship between, diabetes and disability reduced to a large degree,CONCLUSIONS - Even among physically impaired older women, diabetes is associated with a major burden of disability A wide range of impairments and comorbidities explains the diabetes-disability relationship, suggesting that the mechanism for such an association is multifactorial.