title: The effect of diabetes on disability in middle-aged and older adults.
abstract: BACKGROUND
  Physical disability is increasingly recognized as an adverse health consequence of type 2 diabetes in older adults. We studied the effect of diabetes on disability in middle-aged and older adults to: 1) characterize the association of diabetes with physical disability in middle-aged adults, and 2) determine the extent to which the effect of diabetes is explained by related covariates in either or both age groups.
  
  
  METHODS
  We used data from two parallel national panel studies of middle-aged and older adults to study the effect of self-reported diabetes at baseline on disability 2 years later, adjusting for baseline covariates.
  
  
  RESULTS
  Diabetes was strongly associated with subsequent physical disability (measured by a composite variable combining activities of daily living, mobility, and strength tasks) in middle-aged and older adults. Controlling for socioeconomic characteristics and common diabetes-related and unrelated comorbidities and conditions reduced the diabetes effect substantially, but it remained a significant predictor of disability in both groups.
  
  
  CONCLUSIONS
  Our analyses demonstrated that disability is an important diabetes-related health outcome in middle-aged and older adults that should be prevented or mitigated through appropriate diabetes management.
authors.affiliation: Department of Biobehavioral Health, Pennsylvania State University, 315 Health and Human Development East, University Park, PA 16802, USA. law30@psu.edu
authors.forename: Linda A
authors.initials: LA
authors.lastname: Wray
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Ofstedal
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Langa
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Blaum
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D003920:Diabetes Mellitus / Q000534:rehabilitation*; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies