Abstract
Objectives
To examine the incidence of functional or cognitive impairment and its associated
factors in a sample of individuals aged 85 years or older with and without diabetes
mellitus, who were free of significant impairment at baseline.
Design
Longitudinal study.
Setting
Community-based survey study of 7 primary health care centers.
Participants
A total of 167 individuals born in 1924 who completed 2 years of follow-up.
Measurements
Sociodemographic variables, the Barthel Index (BI), the Spanish version of Mini-Mental
State Examination (MEC), the Mini Nutritional Assessment (MNA), the Charlson Comorbidity
Index, and a list of chronic drug prescriptions. A comparative analysis was performed
between diabetic and nondiabetic patients regarding the rate of functional and cognitive
impairment. In addition, in older people with diabetes experiencing incident disability,
an analysis of the potential factors involved was carried out.
Results
The prevalence of diabetes (DM) at baseline in this population was 25.1%. After 2 years
of follow-up, 66.8% of patients with DM had developed a new impairment measured as
38.1% for the defined target of loss of BI of 10 or more and 33.3% for the cognitive
target (MEC scores lower than 24 or loss >4 points in MEC). In a multivariate analysis,
diabetic patients had an increased risk of any new disability (OR 2.05, 95% CI 1.01–4.36;
P = .04).
Logistic regression showed an association between any new disability and baseline
scores of MNA (OR 1.35, 95% CI 1.01–1.82; P = .04) and MEC (OR 1.38, 95% CI 1.02–1.85; P = .003).
Conclusion
This study has identified that in the oldest old, community-dwelling individuals without
evidence of severe functional impairment at baseline, diabetes increases the risk
of incident disability in only 2 years.
Keywords
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Article info
Publication history
Published online: September 27, 2014
Footnotes
This study was funded in part by public funding from the Fondo de Investigación Sanitaria- Instituto de Salud Carlos III, Spain (Number PS09/00552 and RD12/0043/0001) and the European Commission, Belgium (MID-FRAIL Study, FP7-Health-2011 Proposal N° 278803–2).
The authors declare no conflicts of interest.
Identification
Copyright
© 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
