The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland.
Ageing Research Centre, Health Research Institute, School of Allied Health, University of Limerick, Ireland.
J Gerontol A Biol Sci Med Sci. 2021 Apr 30;76(5):906-913. doi: 10.1093/gerona/glaa263.
Diabetes is associated with gait deficits, future falls, and disability; however, it is unclear if associations remain after controlling for relevant confounders. This study investigated (i) the effects of type II diabetes on spatiotemporal gait parameters in community-dwelling older adults and (ii) if diabetes status was independently associated with future falls and disability, after controlling for gait and other confounders.
Baseline data were obtained from 2608 community-dwelling adults (≥60 years) participating in The Irish Longitudinal Study on Ageing (TILDA). Diabetes was identified from self-reported doctors' diagnosis, medications, and glycated hemoglobin levels. Gait characteristics were obtained during single- and dual-task walking using a GAITRite mat (n = 2560). Incident falls and disability were collected over 4 years follow-up (n = 2473). Associations between diabetes status and gait (cross-sectional) and falls and disability (longitudinal) were investigated using regression analysis, adjusting for medications, cardiovascular health, neuropsychological function, and fall-related factors.
Diabetes (prevalence = 9.1%) was cross-sectionally associated with shorter dual-task step length after adjusting for covariates (β = -1.59, 95% CI: -3.10, -0.08, p < .05). Diabetes was independently associated with increased risk of future instrumental activity of daily living (IADL) difficulty in those with no prior difficulty (incidence rate ratio [IRR] = 1.51, 95% CI: 1.08, 2.11, p < .05) although dual-task step length was an important confounder in all disability models. No independent associations between diabetes and falls were observed.
Diabetes was independently associated with shorter dual-task step length and increased risk of future IADL difficulty. Multidimensional interventions addressing poor health and function in those with diabetes may help reduce the risk of gait deficits and future disability.
糖尿病与步态缺陷、未来跌倒和残疾有关；然而，在控制相关混杂因素后，是否仍存在相关性尚不清楚。本研究调查了（i）2 型糖尿病对社区居住的老年成年人时空步态参数的影响，以及（ii）在控制步态和其他混杂因素后，糖尿病状态是否与未来跌倒和残疾独立相关。
基线数据来自参与爱尔兰老龄化纵向研究（TILDA）的 2608 名社区居住的成年人（≥60 岁）。糖尿病通过自我报告的医生诊断、药物和糖化血红蛋白水平确定。使用 GAITRite 垫在单任务和双任务行走时获得步态特征（n=2560）。在 4 年的随访期间收集了跌倒和残疾的发生情况（n=2473）。使用回归分析调查了糖尿病状态与步态（横断面）和跌倒与残疾（纵向）之间的关系，调整了药物、心血管健康、神经心理学功能和与跌倒相关的因素。
在调整了混杂因素后，糖尿病（患病率=9.1%）与双任务步长较短呈横断面相关（β=-1.59，95%CI：-3.10，-0.08，p<.05）。在没有先前困难的情况下，糖尿病与未来工具性日常生活活动（IADL）困难的风险增加独立相关（无困难的发病率比[IRR]为 1.51，95%CI：1.08，2.11，p<.05），尽管在所有残疾模型中，双任务步长都是一个重要的混杂因素。未观察到糖尿病与跌倒之间存在独立关联。
糖尿病与双任务步长较短和未来 IADL 困难的风险增加独立相关。针对糖尿病患者健康和功能不良的多维干预措施可能有助于降低步态缺陷和未来残疾的风险。
