Wu Jasmanda H, Haan Mary N, Liang Jersey, Ghosh Debashis, Gonzalez Hector M, Herman William H
Department of Epidemiology, University of Michigan, School of Public Health, Ann Arbor 48109, USA.
Diabetes Care. 2003 Feb;26(2):314-9. doi: 10.2337/diacare.26.2.314.
Epidemiological studies have demonstrated that older Mexican Americans are at high risk for type 2 diabetes and its complications. Type 2 diabetes leads to a more rapid decline in functional status among older Mexican Americans with diabetes. This study was designed to examine the impact of diabetes on change in self-reported functional status over a 2-year period among older Mexican Americans with diabetes.
We performed a longitudinal analysis with repeated measurements of functional limitations in a cohort of Mexican Americans aged > or =60 years in the Sacramento Area Latino Study on Aging (SALSA). Diabetes was diagnosed on the basis of self-report of physician diagnosis, medication use, and fasting plasma glucose. Functional status was measured by assessment of activities of daily living (ADL) and instrumental activities of daily living (IADL) at baseline and 1 and 2 years.
Of 1,789 SALSA participants, 585 (33%) had diabetes at baseline. Diabetic subjects reported 74% more limitations than nondiabetic subjects in ADL (summary score for number of limitations, 0.99 vs. 0.57; P = 0.002) and 50% more limitations in IADL (summary score for number of limitations, 7.83 vs. 5.25; P < 0.0001). The annual rate of increase in limitations of ADL and IADL was 0.046 and 0.033 (log scale) on each scale among diabetic subjects compared with 0.013 and 0.003 (log scale) among nondiabetic subjects (P < 0.0005). Complications of diabetes were found to increase ADL and IADL limitations among diabetic subjects. Longer duration of diabetes was also associated with an increase in ADL and IADL limitations.
There was lower baseline functional status and a more rapid decline in functional status among older Mexican Americans with diabetes versus those without diabetes.
流行病学研究表明，年长的墨西哥裔美国人患2型糖尿病及其并发症的风险很高。2型糖尿病会导致患有糖尿病的年长墨西哥裔美国人的功能状态更快下降。本研究旨在探讨糖尿病对患有糖尿病的年长墨西哥裔美国人在2年期间自我报告的功能状态变化的影响。
我们在萨克拉门托地区拉丁裔老龄化研究（SALSA）中，对年龄≥60岁的墨西哥裔美国人队列进行了功能受限的重复测量的纵向分析。糖尿病根据医生诊断的自我报告、药物使用情况和空腹血糖进行诊断。在基线、1年和2年时，通过评估日常生活活动（ADL）和工具性日常生活活动（IADL）来测量功能状态。
在1789名SALSA参与者中，585人（33%）在基线时患有糖尿病。糖尿病受试者在ADL方面报告的受限情况比非糖尿病受试者多74%（受限数量的汇总评分，0.99对0.57；P = 0.002），在IADL方面多50%（受限数量的汇总评分，7.83对5.25；P < 0.0001）。糖尿病受试者中ADL和IADL受限的年增长率在每个量表上分别为0.046和0.033（对数尺度），而非糖尿病受试者为0.013和0.003（对数尺度）（P < 0.0005）。发现糖尿病并发症会增加糖尿病受试者的ADL和IADL受限情况。糖尿病病程较长也与ADL和IADL受限增加有关。
与没有糖尿病的年长墨西哥裔美国人相比，患有糖尿病的年长墨西哥裔美国人的基线功能状态较低，功能状态下降更快。
