title: Association Between Chronic Conditions and Physical Function Among Veteran and Non-Veteran Women With Diabetes.
abstract: OBJECTIVE
  To compare the number of chronic conditions among a list of 12 and their association with physical function among postmenopausal non-Veteran and Veteran women with diabetes.
  
  
  METHODS
  Among women with diabetes from the Women's Health Initiative, we compared the average number of chronic conditions between non-Veterans and Veterans and the association between total number of chronic conditions on subsequent RAND-36 physical function. To examine associations between each condition and subsequent physical function, we compared women with diabetes plus one chronic condition to women with diabetes alone using linear regression in separate models for each condition and for non-Veterans and Veterans.
  
  
  RESULTS
  Both non-Veterans (N = 23,542) and Veterans (N = 618) with diabetes had a median of 3 chronic conditions. Decreases in physical function for each additional condition were larger among Veterans than non-Veterans (-6.3 vs. -4.1 points). Decreases in physical function among women with diabetes plus one chronic condition were greater than that reported for diabetes alone for all combinations and were more pronounced among Veterans (non-Veterans: -11.1 to -24.2, Veterans: -16.6 to -40.4 points). Hip fracture, peripheral artery disease, cerebrovascular disease, and coronary disease in combination with diabetes were associated with the greatest decreases in physical function.
  
  
  CONCLUSIONS
  Chronic conditions were common among postmenopausal women with diabetes and were associated with large declines in physical function, particularly among Veterans. Interventions to prevent and reduce the impact of these conditions and facilitate coordination of care among women with diabetes may help them maintain physical function.
authors.affiliation: VA Puget Sound Health Care System, Health Services Research & Development, Seattle, Washington. Department of Health Services, University of Washington School of Public Health, Seattle. kristen.gray2@va.gov.
authors.forename: Kristen E
authors.initials: KE
authors.lastname: Gray
authors.forename: Jodie G
authors.initials: JG
authors.lastname: Katon
authors.affiliation: VA Puget Sound Health Care System, Health Services Research & Development, Seattle, Washington. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Eileen
authors.initials: E
authors.lastname: Rillamas-Sun
authors.affiliation: Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven. Division of General Internal Medicine, University of Connecticut Health Center, Farmington.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Bastian
authors.affiliation: VA Puget Sound Health Care System, Health Services Research & Development, Seattle, Washington. VA Puget Sound Health Care System, General Internal Medicine Service, Seattle, Washington. Department of Medicine, University of Washington, Seattle.
authors.forename: Karin M
authors.initials: KM
authors.lastname: Nelson
authors.affiliation: Division of Epidemiology, Department of Family Medicine and Public Health, University of California, San Diego.
authors.forename: Andrea Z
authors.initials: AZ
authors.lastname: LaCroix
authors.affiliation: VA Puget Sound Health Care System, Health Services Research & Development, Seattle, Washington. Department of Health Services, University of Washington School of Public Health, Seattle. Department of Epidemiology, University of Washington School of Public Health, Seattle.
authors.forename: Gayle E
authors.initials: GE
authors.lastname: Reiber
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000203:Activities of Daily Living; D000368:Aged; D016022:Case-Control Studies; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D002908:Chronic Disease; D060825:Cognitive Dysfunction / Q000453:epidemiology; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006304:Health Status; D006331:Heart Diseases / Q000453:epidemiology; D006620:Hip Fractures / Q000453:epidemiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D016014:Linear Models; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D010003:Osteoarthritis / Q000453:epidemiology; D058729:Peripheral Arterial Disease / Q000453:epidemiology; D014481:United States; D014549:Urinary Incontinence / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*
keywords: Chronic illness; Diabetes; Physical function; Veterans; Women’s issues