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Cited by 52Aging, Health, and DisabilityChronic Disease Management StrategiesFrailty in Older Adults

What can we do to improve physical function in older persons with type 2 diabetes?

Caruso, L. B., Silliman, R. A., Demissie, S., Greenfield, S., Wagner, E. H.·2000·The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
DOI 10.1093/gerona/55.7.m372
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Abstract

BACKGROUND: Older persons with type 2 diabetes are at higher risk for functional impairment than are their age-matched counterparts without-diabetes. We therefore sought to identify factors associated with impaired physical function in older persons with type 2 diabetes by using a cross-sectional study design. METHODS: We studied 1238 persons with type 2 diabetes who were 55 years of age or older and enrolled in the Type II Diabetes Patient Outcomes Research Team (PORT) project. Subjects were primary care patients at a large staff model health maintenance organization who had completed a mailed survey that collected information about demographics (age, race, marital status, income, education, gender, and body mass index [BMI]), health behaviors (exercise, smoking, and alcohol), care and control of diabetes (therapy, self-reported glucose control, home glucose monitoring, and disease duration), mood (Center for Epidemiologic Studies--Depression Scale [CES-D]), comorbidity, and the Short-Form-36 health survey (SF-36). We evaluated the bivariate relationships between the PFI- 10, a 10-item measure of physical function from the SF-36, and candidate independent variables from the domains described previously. Variables that were significant at an a level of .10 were entered into a multiple linear regression model. RESULTS: There were eight independent predictors of impaired physical function (all p < .05, R2 = .40). Factors associated with impaired function in order of their relative importance were as follows: a higher comorbidity score, older age, obesity, lack of regular exercise, CES-D score higher than 20, taking insulin, lower formal education, and abstinence from alcohol. CONCLUSIONS: Increased comorbidity and older age are associated with poorer function, as is the severity of diabetes and less formal education. Exercise, lower BMI, and better mood are associated with better function. Therefore, promoting regular exercise and weight loss, in addition to treating depression, are likely to preserve or even improve the functional status of older persons with type 2 diabetes. Moderate alcohol use may be beneficial as well. The extent to which these relationships persist in prospective studies or clinical trials remains to be evaluated.

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  • Depression predicts fatigue, shortness of breath, and disability in patients with heart disease or COPD, even after adjusting for severity of illness.

    “Depression has been found to predict fatigue, shortness of breath, and disability in patients with heart disease or COPD, even after adjusting for severity of illness.52–56”

    From Anxiety and Depression in COPD (2008) · cites this paper as [54]

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Authors
Caruso, L. B., Silliman, R. A., Demissie, S., Greenfield, S., & Wagner, E. H.
Affiliations
  • Boston University (US)
  • Tufts Medical Center (US)
  • Group Health Cooperative (US)
Corresponding author
Caruso, L. B.
ORCID
Venue
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
Publisher
Oxford University Press (OUP)
Published
2000-07-01
Volume
55
Issue
7
Pages
M372-M377
ISSN
  • 1079-5006 (ISSN-L)
  • 1758-535X
DOI
10.1093/gerona/55.7.m372
OpenAlex
W2113617891
Cited by
52
References
29
Citations by year
2022: 1 · 2021: 1 · 2020: 2 · 2019: 2 · 2017: 1 · 2016: 3 · 2015: 1 · 2014: 3 · 2013: 1 · 2012: 2
FWCI
2.34
Type
journal article
Language
en
Open access
closed
Locations
  • The Journals of Gerontology Series A (publishedVersion)
  • PubMed (publishedVersion)
Funders
Agency for Healthcare Research and Quality (HS06665)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
  • Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
  • Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Keywords
type 2 diabetes, older adults, physical function, functional disability, comorbidities, depression, physical activity, obesity, alcohol consumption, insulin therapy, educational attainment, diabetes management, health behavior
MeSH terms
Activities of Daily Living, Aged, Diabetes Mellitus, Type 2, Female, Humans, Life Style, Male, Middle Aged, Physical Fitness, Surveys and Questionnaires, Socioeconomic Factors

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