Progression of lower-extremity disability in older women with diabetes: the Women's Health and Aging Study.
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.
Volpato
Stefano
S
Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, Maryland, USA. vlt@unife.it
Ferrucci
Luigi
L
Blaum
Caroline
C
Ostir
Glenn
G
Cappola
Anne
A
Fried
Linda P
LP
Fellin
Renato
R
Guralnik
Jack M
JM
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
D006442:Glycated Hemoglobin