What can we do to improve physical function in older persons with type 2 diabetes?
What can we do to improve physical function in older persons with type 2 diabetes?
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DOI：
10.1093/gerona/55.7.m372
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发表时间：
2000-07-01
影响因子：
5.1
通讯作者：
Wagner, EH
中科院分区：
文献类型：
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作者：
Caruso, LB;Silliman, RA;Wagner, EH
背景患有2型糖尿病的老年人患功能障碍的风险高于年龄匹配的无糖尿病老年人。因此，我们试图通过使用横断面研究设计来确定与老年2型糖尿病患者身体功能受损相关的因素。我们研究了1238例年龄在55岁或以上的2型糖尿病患者，这些患者参加了II型糖尿病患者结局研究小组（PORT）项目。受试者是一家大型员工模式健康维护组织的初级保健患者，他们完成了一项邮寄调查，收集了有关人口统计学（年龄、种族、婚姻状况、收入、教育、性别和体重指数[BMI]）、健康行为（锻炼、吸烟和饮酒）、糖尿病护理和控制（治疗、自我报告的血糖控制、家庭血糖监测）的信息。和疾病持续时间），情绪（流行病学中心抑郁量表ICES-DI），合并症，和健康调查简表36（SF-36）。我们评估了PFI-10（SP-36的10项身体功能测量）和先前描述的领域的候选自变量之间的双变量关系。在0.10的水平上显著的变量进入多元线性回归模型。有8个独立的预测因子可以预测身体功能受损（所有p <0.05，R-2 = 0.40）。与功能受损相关的因素按其相对重要性排序如下：较高的合并症评分、年龄较大、肥胖、缺乏规律运动、CES-D评分高于20、服用胰岛素、正规教育程度较低和戒酒。合并症的增加和年龄的增加与功能较差有关，糖尿病的严重程度和正规教育的减少也是如此。运动、较低的BMI和良好的情绪与更好的功能相关。因此，除了治疗抑郁症外，促进定期锻炼和减肥，可能会保持甚至改善老年2型糖尿病患者的功能状态。适量饮酒也可能是有益的。这些关系在前瞻性研究或临床试验中持续存在的程度仍有待评估。
Background. Older persons with type 2 diabetes are at higher risk for functional impairment than are their age-matched counterparts without diabetes. We therefore sought to identify factors associated with impaired physical function in older persons with type 2 diabetes by using a cross-sectional study design.Methods. We studied 1238 persons with type 2 diabetes who were 55 years of age or older and enrolled in die Type II Diabetes Patient Outcomes Research Team (PORT) project. Subjects were primary care patients at a large staff model health maintenance organization who had completed a mailed survey that collected information about demographics (age, race, marital status, income, education, gender, and body mass index [BMI]), health behaviors (exercise, smoking, and alcohol), care and control of diabetes (therapy, self-reported glucose control, home glucose monitoring. and disease duration), mood (Center for Epidemiologic Studies-Depression Scale ICES-DI), comorbidity, and the Short-Form-36 health survey (SF-36).We evaluated the bivariate relationships between the PFI-10 a 10-item measure of physical function from the SP-36, and candidate independent variables from the domains described previously. Variables that were significant at an a level of .10 were entered into a multiple linear regression model.Results. There were eight independent predictors of impaired physical function (all p < .05, R-2 = .40). Factors associated with impaired function in order of their relative importance were as follows: a higher comorbidity score, older age, obesity, lack of regular exercise, CES-D score higher than 20, taking insulin, lower formal education, and abstinence from alcohol.Conclusions. Increased comorbidity and older age are associated with poorer function, as is the severity of diabetes and less formal education. Exercise, lower BMI, and better mood are associated with better function. Therefore, promoting regular exercise and weight loss, in addition to treating depression, are likely to preserve or even improve the functional status of older persons with type 2 diabetes. Moderate alcohol use may be beneficial as well. The extent to which these relationships persist in prospective studies or clinical trials remains to be evaluated.