title: Diabetes mellitus and its association with central obesity and disability among older adults: a global perspective.
abstract: The aim of the study was to evaluate the association between various factors and diabetes type II (DM) with a particular emphasis on indicators of central obesity, and to compare the effect of DM on disability among elder populations (≥ 50 years old) in nine countries. Data were available for 52,946 people aged ≥ 18 years who participated in the WHO Study on global AGEing and adult health and the Collaborative Research on Ageing in Europe studies conducted between 2007 and 2012. DM was defined as self-report of physician diagnosis. Height, weight, and waist circumference were measured. Disability status was assessed with the WHODAS II questionnaire. The overall prevalence of DM was 7.9% and ranged from 3.8% (Ghana) to 17.6% (Mexico). A 10 cm increase in waist circumference and waist-to-height ratio of >0.5 were associated with a significant 1.26 (India) to 1.77 (Finland), and 1.68 (China, Spain) to 5.40 (Finland) times higher odds for DM respectively. No significant associations were observed in Mexico and South Africa. DM was associated with significantly higher disability status in all countries except Mexico in the model adjusted for demographics and smoking. The inclusion of chronic conditions associated with diabetes in the model attenuated the coefficients in varying degrees depending on the country. A considerable proportion of the studied older population had DM. Central obesity may be a key factor for the prevention of DM among older populations globally. Prevention of DM especially among the older population globally may contribute to reducing the burden of disability.
authors: Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujades, 42, 08830 Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain.
authors: Stefanos
authors: S
authors: Tyrovolas
authors: Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujades, 42, 08830 Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain.
authors: Ai
authors: A
authors: Koyanagi
authors: Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Institut d'Investigacions Biomèdiques Sant Pau (IIB Sant Pau), Sant Antoni Maria Claret 167, 08025 Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra 08193 Cerdanyola del Vallès, Spain.
authors: Noe
authors: N
authors: Garin
authors: Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujades, 42, 08830 Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain.
authors: Beatriz
authors: B
authors: Olaya
authors: Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Instituto de Investigación Sanitaria Princesa (IP), Hospital Universitario la Princesa, Madrid, Spain.
authors: Jose Luis
authors: JL
authors: Ayuso-Mateos
authors: Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Instituto de Investigación Sanitaria Princesa (IP), Hospital Universitario la Princesa, Madrid, Spain.
authors: Marta
authors: M
authors: Miret
authors: Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland.
authors: Somnath
authors: S
authors: Chatterji
authors: Department of Medical Sociology, Jagiellonian University Medical College, Krakow, Poland.
authors: Beata
authors: B
authors: Tobiasz-Adamczyk
authors: National Institute for Health and Welfare, Helsinki, Finland.
authors: Seppo
authors: S
authors: Koskinen
authors: Neurology, Public Health and Disability Unit, Neurological Institute "Carlo Besta" Foundation IRCCS (Istituto di ricovero e cura a carattere scientifico), Milan, Italy.
authors: Matilde
authors: M
authors: Leonardi
authors: Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujades, 42, 08830 Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain. Electronic address: jmharo@pssjd.org.
authors: Josep Maria
authors: JM
authors: Haro
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D004185:Disability Evaluation; D005260:Female; D006306:Health Surveys; D006801:Humans; D038622:Internationality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D056128:Obesity, Abdominal / Q000453:epidemiology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D055105:Waist Circumference; D065927:Waist-Height Ratio; D014944:World Health Organization
keywords: Diabetes mellitus; Disability; Obesity; Older adults; Waist circumference; Waist-to-height ratio