title: Diabetes mellitus as a risk factor for functional and cognitive decline in very old people: the Octabaix study.
abstract: OBJECTIVE
  To examine the incidence of functional or cognitive impairment and its associated factors in a sample of individuals aged 85 years or older with and without diabetes mellitus, who were free of significant impairment at baseline.
  
  
  METHODS
  Longitudinal study.
  
  
  METHODS
  Community-based survey study of 7 primary health care centers.
  
  
  METHODS
  A total of 167 individuals born in 1924 who completed 2 years of follow-up.
  
  
  METHODS
  Sociodemographic variables, the Barthel Index (BI), the Spanish version of Mini-Mental State Examination (MEC), the Mini Nutritional Assessment (MNA), the Charlson Comorbidity Index, and a list of chronic drug prescriptions. A comparative analysis was performed between diabetic and nondiabetic patients regarding the rate of functional and cognitive impairment. In addition, in older people with diabetes experiencing incident disability, an analysis of the potential factors involved was carried out.
  
  
  RESULTS
  The prevalence of diabetes (DM) at baseline in this population was 25.1%. After 2 years of follow-up, 66.8% of patients with DM had developed a new impairment measured as 38.1% for the defined target of loss of BI of 10 or more and 33.3% for the cognitive target (MEC scores lower than 24 or loss >4 points in MEC). In a multivariate analysis, diabetic patients had an increased risk of any new disability (OR 2.05, 95% CI 1.01-4.36; P = .04). Logistic regression showed an association between any new disability and baseline scores of MNA (OR 1.35, 95% CI 1.01-1.82; P = .04) and MEC (OR 1.38, 95% CI 1.02-1.85; P = .003).
  
  
  CONCLUSIONS
  This study has identified that in the oldest old, community-dwelling individuals without evidence of severe functional impairment at baseline, diabetes increases the risk of incident disability in only 2 years.
authors.affiliation: Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: fformiga@bellvitgehospital.cat.
authors.forename: Francesc
authors.initials: F
authors.lastname: Formiga
authors.affiliation: Primary Healthcare Centre 'El Plà' CAP-I, Sant Feliu de Llobregat, Barcelona, Spain.
authors.forename: Assumpta
authors.initials: A
authors.lastname: Ferrer
authors.affiliation: Clinical Laboratory Service L'Hospitalet, Barcelona, Spain.
authors.forename: Glòria
authors.initials: G
authors.lastname: Padrós
authors.affiliation: Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Global Institute of Public Health and Health Policy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Corbella
authors.affiliation: Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Cos
authors.affiliation: Institute for Diabetes in Older People (IDOP), Bedfordshire University, UK.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Sinclair
authors.affiliation: Geriatric Service, Getafe University Hospital, Madrid, Spain.
authors.forename: Leocadio
authors.initials: L
authors.lastname: Rodríguez-Mañas
mesh_terms: D000203:Activities of Daily Living; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000453:epidemiology*; D048909:Diabetes Complications / Q000453:epidemiology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D015995:Prevalence; D011320:Primary Health Care; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013030:Spain
keywords: Diabetes mellitus; cognitive status; disability; functional status; geriatric assessment; oldest old