title: Progression of lower-extremity disability in older women with diabetes: the Women's Health and Aging Study.
abstract: OBJECTIVE
  Older patients with diabetes are more likely to have a higher prevalence of multiple risk factors for physical disability, as a result of diabetic complications. We evaluated the pace of decline in lower-extremity function and the risk for progression of disability in older women with diabetes.
  
  
  METHODS
  We conducted a 3-year longitudinal cohort study of a random sample of 729 physically impaired older women (age > or =65 years) living in the community (Baltimore, MD). Diabetes was ascertained by standard criteria. Self-reported functional status and objective performance measures were assessed at baseline and over six semiannual follow-up visits.
  
  
  RESULTS
  The baseline prevalence of diabetes was 14.4%. After adjustment for age and compared with women without diabetes, those with diabetes had an RR of 1.8 (95% CI 1.3-2.5) for incident mobility disability and 1.6 (1.2-2.1) for incident activity of daily living disability. The increased incidence of new disability associated with diabetes was paralleled by a greater decline in objective measures of lower-extremity function. Adjustment for multiple risk factors for disability did not significantly attenuate the risk for disability associated with diabetes.
  
  
  CONCLUSIONS
  In older patients, impaired lower-extremity function is a long-term diabetic complication. Comprehensive assessment of older diabetic patients should include a standardized evaluation of lower-extremity performance.
authors.affiliation: Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, Maryland, USA. vlt@unife.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Volpato
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
authors.forename: Caroline
authors.initials: C
authors.lastname: Blaum
authors.forename: Glenn
authors.initials: G
authors.lastname: Ostir
authors.forename: Anne
authors.initials: A
authors.lastname: Cappola
authors.forename: Linda P
authors.initials: LP
authors.lastname: Fried
authors.forename: Renato
authors.initials: R
authors.lastname: Fellin
authors.forename: Jack M
authors.initials: JM
authors.lastname: Guralnik
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000375:Aging; D015331:Cohort Studies; D003925:Diabetic Angiopathies / Q000453:epidemiology* / Q000503:physiopathology*; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007866:Leg; D008137:Longitudinal Studies; D015999:Multivariate Analysis; D012307:Risk Factors; D016387:Women's Health
chemical_list: D006442:Glycated Hemoglobin