Gray Kristen E, Katon Jodie G, Rillamas-Sun Eileen, Bastian Lori A, Nelson Karin M, LaCroix Andrea Z, Reiber Gayle E
VA Puget Sound Health Care System, Health Services Research & Development, Seattle, Washington. Department of Health Services, University of Washington School of Public Health, Seattle.
VA Puget Sound Health Care System, Health Services Research & Development, Seattle, Washington. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Gerontologist. 2016 Feb;56 Suppl 1(Suppl 1):S112-25. doi: 10.1093/geront/gnv675.
To compare the number of chronic conditions among a list of 12 and their association with physical function among postmenopausal non-Veteran and Veteran women with diabetes.
Among women with diabetes from the Women's Health Initiative, we compared the average number of chronic conditions between non-Veterans and Veterans and the association between total number of chronic conditions on subsequent RAND-36 physical function. To examine associations between each condition and subsequent physical function, we compared women with diabetes plus one chronic condition to women with diabetes alone using linear regression in separate models for each condition and for non-Veterans and Veterans.
Both non-Veterans (N = 23,542) and Veterans (N = 618) with diabetes had a median of 3 chronic conditions. Decreases in physical function for each additional condition were larger among Veterans than non-Veterans (-6.3 vs. -4.1 points). Decreases in physical function among women with diabetes plus one chronic condition were greater than that reported for diabetes alone for all combinations and were more pronounced among Veterans (non-Veterans: -11.1 to -24.2, Veterans: -16.6 to -40.4 points). Hip fracture, peripheral artery disease, cerebrovascular disease, and coronary disease in combination with diabetes were associated with the greatest decreases in physical function.
Chronic conditions were common among postmenopausal women with diabetes and were associated with large declines in physical function, particularly among Veterans. Interventions to prevent and reduce the impact of these conditions and facilitate coordination of care among women with diabetes may help them maintain physical function.
比较12种慢性病在绝经后非退伍军人和患有糖尿病的退伍军人女性中的数量，以及它们与身体功能的关联。
在参与女性健康倡议的糖尿病女性中，我们比较了非退伍军人和退伍军人之间慢性病的平均数量，以及慢性病总数与随后的兰德36项身体功能之间的关联。为了研究每种疾病与随后身体功能之间的关联，我们在针对每种疾病以及非退伍军人和退伍军人的单独模型中，使用线性回归比较了患有糖尿病加一种慢性病的女性与仅患有糖尿病的女性。
患有糖尿病的非退伍军人（N = 23,542）和退伍军人（N = 618）的慢性病中位数均为3种。退伍军人中每增加一种疾病，身体功能的下降幅度比非退伍军人更大（-6.3分对-4.1分）。对于所有组合，患有糖尿病加一种慢性病的女性的身体功能下降幅度大于仅患有糖尿病的女性，并且在退伍军人中更为明显（非退伍军人：-11.1至-24.2分，退伍军人：-16.6至-40.4分）。髋部骨折、外周动脉疾病、脑血管疾病和冠状动脉疾病与糖尿病合并时，与身体功能下降幅度最大有关。
慢性病在绝经后患有糖尿病的女性中很常见，并且与身体功能的大幅下降有关，尤其是在退伍军人中。预防和减少这些疾病的影响并促进糖尿病女性护理协调的干预措施可能有助于她们维持身体功能。
