Diabetes mellitus and gait dysfunction: possible explanatory factors
Open accessAbstract
Background and Objective: Gait characteristics differ in individuals with diabetes compared with those without diabetes. Limited information regarding potential explanatory factors for this association exists. This study examined the association between diabetes and gait characteristics in older adults and explored potential explanatory factors. Design: A cross-sectional, observational study design was used. Methods: At the 1998–1999 clinic visit, 558 ambulatory older adults (mean age=79 years) from the Pittsburgh site of the Cardiovascular Health Study had an assessment of their gait characteristics, diabetes, health status, cognition, mood, lower-extremity circulation and sensation, vision, lower-extremity strength (force-producing capacity), physical activity, and body mass index (BMI). A series of linear regression models were developed to examine the association between diabetes and gait characteristics and to examine potential explanatory factors for the associations. Results: Diabetes was related to gait speed (β=−.06 m/s); however, the association was partially explained by health status variables, cognition, mood, lower-extremity circulation and sensation, visual impairment, lower-extremity strength, physical activity, and BMI. Health status and lower-extremity strength each explained the greatest proportion of the association (β reduced 66% by each). Diabetes was related to step width (β=.02 m), and the association could not be explained by the examined factors. Conclusions: Diabetes was associated with gait alterations in older adults. Slowed gait speed appears to be secondary to the peripheral effect of the disease on other body systems. The effect of diabetes on step width was not explained in the analyses and may be related to peripheral motor nerve function or central influences of the disease, which could not be assessed in this study.
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In older people, chronic medical conditions such as hypertension, diabetes mellitus, and dyslipidemia are associated with lower walking speed and greater decline in walking speed.
“Chronic medical conditions such as hypertension, diabetes mellitus, and dyslipidemia were associated with lower walking speed and greater decline in walking speed in older people (106, 107).”
From Health Consequences of Sarcopenic Obesity: A Narrative Review (2020) · cites this paper as [107]
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- Authors
- Brach, J. S., Talkowski, J. B., Strotmeyer, E. S., & Newman, A. B.
- Affiliations
- University of Pittsburgh (US)
- Corresponding author
- Brach, Jennifer S
- Venue
- Physical Therapy
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-11-01
- Volume
- 88
- Issue
- 11
- Pages
- 1365-1374
- ISSN
- 0031-9023 (ISSN-L)
- 1538-6724
- PMC
- PMC2579906
- OpenAlex
- W2121026234
- Cited by
- 101
- References
- 44
- Citations by year
- 2026: 6 · 2025: 1 · 2024: 9 · 2023: 2 · 2022: 6 · 2021: 6 · 2020: 7 · 2019: 9 · 2018: 12 · 2017: 3 · 2016: 4 · 2015: 8 · 2014: 8 · 2013: 4 · 2012: 5
- FWCI
- 9.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Physical Therapy (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (n01hc045133-001, n01hc085079-024, n01hc015103-009, n01hc085086-022, n01hc55222-0-0-0, n01hc075150-004, n01hc035129-010)
- National Institute on Aging (K23AG026766, TG32 AG00181, P30AG024827)
- National Heart, Lung, and Blood Institute (N01HC15103, N01HC‐75150, N01 HC85086, N01 HC55222, N01‐HC‐45133, U01HL080295, N01-HC85079, N01HC35129)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- diabetes mellitus, gait disturbance, older adults, walking speed, step width, health status, cognition, mood, lower limb strength, peripheral neuropathy, physical activity, body mass index, Cardiovascular Health Study
- MeSH terms
- Aged, Cognition, Cross-Sectional Studies, Diabetes Mellitus, Female, Gait, Health Status, Humans, Longitudinal Studies, Male, Multicenter Studies as Topic, Geriatric Assessment, Body Mass Index, Linear Models, Muscle Strength
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