title: Physical function limitations among middle-aged and older adults with prediabetes: one exercise prescription may not fit all.
abstract: OBJECTIVE
  To describe the prevalence of physical function limitations among a nationally representative sample of adults with prediabetes.
  
  
  METHODS
  We performed a cross-sectional analysis of 5,991 respondents≥53 years of age from the 2006 wave of the Health and Retirement Study. All respondents self-reported physical function limitations and comorbidities (chronic diseases and geriatric conditions). Respondents with prediabetes reported no diabetes and had a measured glycosylated hemoglobin (HbA1c) of 5.7-6.4%. Descriptive analyses and logistic regressions were used to compare respondents with prediabetes versus diabetes (diabetes history or HbA1c≥6.5%) or normoglycemia (no diabetes history and HbA1c<5.7%).
  
  
  RESULTS
  Twenty-eight percent of respondents≥53 years of age had prediabetes; 32% had mobility limitations (walking several blocks and/or climbing a flight of stairs); 56% had lower-extremity limitations (getting up from a chair and/or stooping, kneeling, or crouching); and 33% had upper-extremity limitations (pushing or pulling heavy objects and/or lifting>10 lb). Respondents with diabetes had the highest prevalence of comorbidities and physical function limitations, followed by those with prediabetes, and then normoglycemia (P<0.05). Compared with respondents with normoglycemia, respondents with prediabetes had a higher odds of having functional limitations that affected mobility (odds ratio [OR] 1.48), the lower extremities (OR 1.35), and the upper extremities (OR 1.37) (all P<0.01). The higher odds of having lower-extremity limitations remained after adjusting for age, sex, and body mass index (OR 1.21, P<0.05).
  
  
  CONCLUSIONS
  Comorbidities and physical function limitations are prevalent among middle-aged and older adults with prediabetes. Effective lifestyle interventions to prevent diabetes must accommodate physical function limitations.
authors.affiliation: Corresponding author: Pearl G. Lee, pearllee@med.umich.edu.
authors.forename: Pearl G
authors.initials: PG
authors.lastname: Lee
authors.forename: Christine T
authors.initials: CT
authors.lastname: Cigolle
authors.forename: Jinkyung
authors.initials: J
authors.lastname: Ha
authors.forename: Lillian
authors.initials: L
authors.lastname: Min
authors.forename: Susan L
authors.initials: SL
authors.lastname: Murphy
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Blaum
authors.forename: William H
authors.initials: WH
authors.lastname: Herman
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000517:prevention & control; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000503:physiopathology* / Q000628:therapy*