Diabetes and incidence of functional disability in older women
Diabetes and incidence of functional disability in older women
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DOI：
10.2337/diacare.25.1.61
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发表时间：
2002-01-01
期刊：
影响因子：
16.2
通讯作者：
Nevitt, MC
中科院分区：
文献类型：
--
作者：
Gregg, EW;Mangione, CM;Nevitt, MC
研究设计与方法：我们分析了8,344名参加骨质疏松性骨折研究的女性的数据，这是一组年龄大于或等于65岁的女性的前瞻性队列。通过问卷调查和体格检查评估糖尿病(n=527，患病率6.3%)和并发症(冠心病、中风、关节炎、抑郁和视力障碍)。事件残疾，定义为开始无法完成一个或多个主要功能任务(步行0.25英里，攀登10步，执行家务，购物，做饭)，通过问卷调查超过12年。结果：糖尿病女性任何功能障碍的年发生率为9.8%，非糖尿病女性为4.8%。与糖尿病相关的特定任务的年龄调整危险比(HRR)从做家务的2.12(1.82-2.48)到步行两到三个街区的2.50(2.05-3.04)不等。在调整了基线(BMI、体力活动、雌激素使用、基线功能状态、视力障碍和婚姻状况)和合并症(心脏病、中风、抑郁症和关节炎)的潜在混杂因素后，糖尿病仍然与任何意外残疾风险增加42%和特定任务残疾风险增加53%-98%相关。在患有糖尿病的女性中，年龄较大、BMI较高、冠心病、关节炎、缺乏体力活动和严重视力障碍与残疾独立相关。结论-糖尿病与功能性残疾的发生率增加有关，这可能进一步侵蚀健康状况和生活质量。
OBJECTIVE - To examine the relationship between diabetes and the incidence of functional disability and to determine the predictors of functional disability among older women with diabetes.RESEARCH DESIGN AND METHODS - We analyzed data from 8,344 women enrolled in the Study of Osteoporotic Fractures, a prospective cohort of women aged greater than or equal to 65 years. Diabetes (n = 527, 6.3% prevalence) and comorbidities (coronary heart disease, stroke, arthritis, depression, and visual impairment) were assessed by questionnaire and physical examination. Incident disability, defined as onset of inability to do one or more major functional tasks (walking 0.25 mile, climbing 10 steps, performing household chores, shopping, and cooking meals), was assessed by questionnaire over 12 years.RESULTS - The yearly incidence of any functional disability was 9.8% among women with diabetes and 4.8% among women without diabetes. The age-adjusted hazard rate ratio (HRR) of disability for specific tasks associated with diabetes ranged from 2.12 (1.82-2.48) for ling housework to 2.50 (2.05-3.04) for walking two to three blocks. After adjustment for potential confounders at baseline (BMI, physical activity, estrogen use, baseline functional status, visual impairment, and marital status) and comorbidities (heart disease, stroke, depression, and arthritis), diabetes remained associated with a 42% increased risk of any incident disability and a 53-98% increased risk of disability for specific tasks. Among women with diabetes, older age, higher BMI, coronary heart disease, arthritis, physical inactivity, and severe visual impairment at baseline Were each independently associated with disability.CONCLUSIONS - Diabetes is associated with an increased incidence of functional disability, which is likely to further erode health status and quality of life.