Patterns of disability related to diabetes mellitus in older women.
OBJECTIVE
To identify pattern(s) of disability related to diabetes in older women and to determine the extent to which disability is mediated by selected diabetes complications.


METHODS
Cross-sectional analysis of data from a population-based study composed of a representative sample of 3570 noninstitutionalized women aged 65 years and older living in the Baltimore metropolitan area who agreed to be screened for the Women's Health and Aging Study.


RESULTS
483 (13.5%) of the women reported physician-diagnosed diabetes. Compared to women without diabetes, women with diabetes were significantly more likely to report difficulty in 14 of 15 daily tasks, including walking 2-3 blocks, lifting 10 pounds, using the telephone, and bathing (range of odds ratios [OR] 1.5-2.8; all p <.01). After adjustment for age, race, and marital status, women with diabetes were about twice as likely to report difficulty in any one of four functioning groups (mobility, upper extremity, higher functioning tasks, or self-care) (OR 2.2; 95% confidence interval [CI] 1.8-2.7), and over three times as likely to report difficulty in a group combining higher functioning and self-care tasks (OR 3.2; 95% CI 2.4-4.1). Adjustment for self-reported heart disease, stroke, high blood pressure, and visual problems did not attenuate these associations.


CONCLUSIONS
Diabetes is strongly associated with a wide range of disabilities in older women. This association does not appear to be mediated by prevalent diabetes complications and risks, heart disease, high blood pressure, stroke, or eye disease. Other complications of diabetes (e.g., neuropathy, peripheral vascular disease) may mediate diabetes-associated disability in older adults.
Maty
Siobhan C
SC
Department of Epidemiology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Fried
Linda P
LP
Volpato
Stefano
S
Williamson
Jeff
J
Brancati
Frederick L
FL
Blaum
Caroline S
CS
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000175:diagnosis; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D016017:Odds Ratio; D011336:Probability; D011379:Prognosis; D011788:Quality of Life; D012016:Reference Values; D012307:Risk Factors; D012720:Severity of Illness Index; D018434:Sickness Impact Profile