title: Early declines in physical function among aging adults with type 2 diabetes.
abstract: OBJECTIVE
  Type 2 diabetes (T2DM) is associated with reduced physical function and early disability. We hypothesized that changes in physical function occur early and differ by age. Our aims were to determine and compare differences in and predictors of physical function in older and younger adults with T2DM.
  
  
  METHODS
  Eighty adults completed six-minute walk distance (6MWD) tests, wore wrist actigraphy for 5days and completed diabetes health and symptom surveys. Comparative and bivariate analyses were completed to assess differences between age groups determined by serial Box's M-plot analyses.
  
  
  RESULTS
  6MWD was low (476.9±106.2m), and negatively associated with female gender, age, neuropathic pain, diabetes duration, BMI, poor sleep quality, and fatigue and positively with habitual activity and education (p<0.05). Covariance matrices changed at age 59. In subjects age <58, 6MWD was predicted by gender, sleep quality, and neuropathic pain (R2=0.593, p<0.001). In those age ≥59, 6MWD was predicted by diabetes duration, education, and habitual activity (R2=0.554, p<0.001). There were no shared predictors of 6MWD between groups.
  
  
  CONCLUSIONS
  T2DM is associated with early declines in physical function; the predictors of which change in midlife. Therapies to maintain or improve physical function should be tailored by age, pain symptoms, and habitual activity levels.
authors.affiliation: Department of Biobehavioral Health Science, University of Illinois at Chicago College of Nursing, Chicago, IL. Electronic address: Fritschi@uic.edu.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Fritschi
authors.affiliation: Department of Biobehavioral Health Science, University of Illinois at Chicago College of Nursing, Chicago, IL.
authors.forename: Ulf Gunnar
authors.initials: UG
authors.lastname: Bronas
authors.affiliation: University of Illinois at Chicago College of Nursing, Chicago, IL.
authors.forename: Chang G
authors.initials: CG
authors.lastname: Park
authors.affiliation: Department of Biobehavioral Health Science, University of Illinois at Chicago College of Nursing, Chicago, IL; Research & Development, Edward Hines Jr., VA Hospital, Hines, IL.
authors.forename: Eileen G
authors.initials: EG
authors.lastname: Collins
authors.affiliation: Department of Biobehavioral Health Science, University of Illinois at Chicago College of Nursing, Chicago, IL.
authors.forename: Laurie
authors.initials: L
authors.lastname: Quinn
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D019588:Aging, Premature / Q000150:complications* / Q000503:physiopathology; D015331:Cohort Studies; D017281:Cost of Illness; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003929:Diabetic Neuropathies / Q000503:physiopathology; D006233:Persons with Disabilities; D018450:Disease Progression; D004522:Educational Status; D015444:Exercise; D005221:Fatigue / Q000150:complications / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D009437:Neuralgia / Q000150:complications / Q000503:physiopathology; D011788:Quality of Life; D057566:Self Report; D012737:Sex Factors
keywords: Diabetes complications; Diabetes symptoms; Physical activity; Physical function testing; Six-minute walk distance