Diabetes, race, and functional limitations in older U.S. men and women.
OBJECTIVE
The presence of diabetes is associated with increased odds of difficulties in functional tasks but it remains unclear if the burden is similar by race.


METHODS
Our study included 122,004 non-Hispanic Black (NHB) and non-Hispanic White (NHW) adults ≥50 years from the U.S. National Health Interview Survey (2001-2012). Diabetes was defined as self-reported diagnosis or medication use. Functional limitations were defined as any self-reported difficulty in performing mobility tasks, general physical activities (GPA), or leisure and social activities (LSA). Logistic regression models were created to investigate the relationship of race with functional limitations accounting for key covariates, among men and women, by diabetes status.


RESULTS
Among older U.S. adults, NHB versus NHW women without diabetes had a higher odds of limitations in mobility (OR=1.39, 1.30-1.49) and LSA (OR=1.13, 1.05-1.23) without diabetes but a similar odds of these limitations with diabetes by race, after adjusting for age, income, education, obesity, arthritis, heart disease, stroke, COPD, and cancer. Interestingly, NHB versus NHW women had significantly lower odds of GPA, irrespective of diabetes status. However, NHB versus NHW men with diabetes had a persistently higher odds for mobility and LSA limitations with diabetes as follows: mobility (OR=1.30, 1.12-1.51) and LSA limitations (OR=1.07, 1.06-1.34). The interaction of race and diabetes was significant among women for mobility limitations (p<0.01), but not men.


CONCLUSIONS
The burden of functional limitations differs by race among both men and women with diabetes. Future studies should examine mechanisms underlying these differences to prevent progression to disability in older adults with diabetes.
Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, The Johns Hopkins University, Baltimore, MD, USA; Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, MD, USA. Electronic address: rrastogi@jhmi.edu.
Rita Rastogi
RR
Kalyani
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Diana C
DC
Rodriguez
Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Division of General Internal Medicine, Department of Medicine, The Johns Hopkins University, Baltimore, MD, USA.
Hsin-Chieh
HC
Yeh
Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, The Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Sherita H
SH
Golden
Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Roland J
RJ
Thorpe
D000203:Activities of Daily Living; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000208:ethnology* / Q000503:physiopathology / Q000534:rehabilitation; D004185:Disability Evaluation; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D000068079:Motor Disorders / Q000208:ethnology* / Q000209:etiology / Q000503:physiopathology; D015995:Prevalence; D044469:Racial Groups; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
Diabetes; Epidemiology; Men's health; Mobility; Physical function; Race