title: Diabetes and disability in older Australians: The Australian Diabetes, Obesity and Lifestyle (AusDiab) study.
abstract: OBJECTIVE
  To examine the association between diabetes and disability in older Australians and to identify factors that explain this association.
  
  
  METHODS
  We analysed data from a subsample of the Australian Diabetes, Obesity and Lifestyle study (AusDiab) cohort. Disability was measured using the Katz questionnaire in those aged 60years or over and was defined as some difficulty in any of the Katz activities of daily living (ADL) questions.
  
  
  RESULTS
  Among 2373 study participants aged 60years or above who had a disability assessment at the third wave of follow-up (2011-12), 255 (11%) reported at least some disability. Participants with diabetes at baseline had higher odds of disability at 12years [odds ratio=2.41 (95% CI 1.60-3.64)] as compared to individuals with normal glucose tolerance; these patterns were similar for men and women. There was no association between baseline prediabetes and disability [OR=1.27 (95% CI 0.91-1.78)]. Baseline body mass index (BMI) and cardiometabolic factors (hypertension, prior cardiovascular disease, impaired glomerular filtration rate, triglycerides and high-density lipoproteins) were important in explaining the increased odds of disability. BMI and cardiometabolic factors together explained 65% of the diabetes-associated odds of disability at 12years.
  
  
  CONCLUSIONS
  In older Australians, we showed that baseline diabetes more than doubled the odds of reporting disability at 12years, with BMI and cardiometabolic factors accounting for much of this relationship. These findings suggest that interventions targeting weight control, and prevention and treatment of cardiometabolic factors may prevent disability associated with diabetes and promote healthy aging.
authors.affiliation: Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. Electronic address: digsu.koye@bakeridi.edu.au.
authors.forename: Digsu N
authors.initials: DN
authors.lastname: Koye
authors.affiliation: Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Shaw
authors.affiliation: Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: Dianna J
authors.initials: DJ
authors.lastname: Magliano
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology; D048909:Diabetes Complications / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology*; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D011236:Prediabetic State / Q000150:complications / Q000453:epidemiology; D012307:Risk Factors
keywords: Diabetes; Disability; Older Australians; Prediabetes