title: Association of geriatric conditions and cardiovascular diseases with disability in older adults with diabetes: findings from a nationally representative survey.
abstract: OBJECTIVE
  To examine how diabetes in combination with cardiovascular diseases (hypertension, heart disease and stroke) and geriatric conditions (cognitive impairment and depressive symptoms) affects the odds of disability in older adults.
  
  
  METHODS
  We analyzed data from a nationally representative sample of people aged 65 years and over (n=2727) participating in the 2005 National Health Interview Survey in Taiwan. A total of 473 participants had a history of self-reported physician diagnosed diabetes. Disability was defined as reporting limitations in one or more tasks of activities of daily living (ADL), instrumental activities of daily living (IADL) or general physical activities (GPA). The Mini-Mental State Examination was used to assess cognitive function. The Center for Epidemiologic Studies Depression Scale was used to assess depressive symptoms.
  
  
  RESULTS
  After adjustment for other factors, cardiovascular diseases and geriatric conditions independently contributed to the excess odds of disability among participants with diabetes. Participants who had diabetes combined with cardiovascular diseases and geriatric conditions had odds ratios for ADL, IADL and GPA disability of 18.02 (95% CI 5.13-63.34), 7.95 (95% CI 4.07-15.50) and 5.89 (95% CI 3.19-10.90), respectively.
  
  
  CONCLUSIONS
  Our results highlight the high prevalence of co-occurrence of cardiovascular diseases with geriatric conditions in people with diabetes. Furthermore, the combined presence of these diseases and conditions is strongly associated with an excess odds of disability. These findings highlight the critical importance of preventing cardiovascular disease morbidity, and improving depressed mood and cognitive function in order to reduce disability risk in older adults with diabetes.
authors.affiliation: Department of Health Care Management, Chang Gung University, Tao-Yuan, Taiwan. clli@mail.cgu.edu.tw
authors.forename: Chia-Lin
authors.initials: CL
authors.lastname: Li
authors.forename: Yi-Chen
authors.initials: YC
authors.lastname: Chiu
authors.forename: Hsing-Yi
authors.initials: HY
authors.lastname: Chang
authors.forename: Kuang-Hung
authors.initials: KH
authors.lastname: Hsu
authors.forename: Yuh-Bin
authors.initials: YB
authors.lastname: Bai
authors.forename: Hui-Hsuan
authors.initials: HH
authors.lastname: Wang
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000534:rehabilitation; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D011159:Population Surveillance; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology