Transitions of Functional Disabilities in the United States Elderly with Diabetes Mellitus

Based on the Disablement Process Framework developed by Verbrugge and Jette (1994), this study entailed an empirical examination of the association between functional status changes among U.S. elders with diabetes and the risk factors, including sociodemographic, health, lifestyle, and extra-individual factors. The main data source was the Assets and Health Dynamics Among the Oldest Old Wave 1 (1993) and Wave 2 (1995). The study samples included 7,443 elders aged 70 years and over, of which 993 were diabetic and 6,450 were non-diabetic. Descriptive statistics and multinomial logit regression analyses were used to examine the associations between functional status changes and risk factors among the whole sample of elders, and among elders with and without diabetes. The descriptive statistics reveal significant differences in the prevalence of impairments in activities of daily living (ADLs) and of mobility functions at Wave 1 between diabetic and non-diabetic elders, and between diabetic women and men. In each case, the former had a higher prevalence than the latter. The empirical findings suggest that diabetic elders who used either medication or insulin injections had higher odds of experiencing ADL and mobility function declines compared to non-diabetic elders. Factors affected functional status declines for both diabetic and non-diabetic elders were age, chronic pain, baseline mobility function difficulties, stroke, cancer, and arthritis. In addition, taking medication, insulin injection (both reflecting aspects of disease severity), as well as higher income, low BMI, and Medicaid, were found to be positively associated with functional status decline among diabetics. Finally, college education, separated or divorced, heart condition, and primary insurance, were found to be negatively associated with functional status decline among diabetics. The empirical findings have implications that are related to the individual management of diabetes, group disease management programs, promotion of education for current and potential diabetics, smoking cessation support, and the importance of health insurance. Each of these areas should be targeted by policy changes to delay the onset of disease and its resulting disabilities for diabetic elders, healthy adults, and elders in the general population. The current study's approach should be replicated in a larger sample of diabetic elders.

risk factors

16290