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DIABETES OBESITY and METABOLISM, 10. 9 (2008): 726-732. BLACKWELL PUBLISHING Wang, Ching-Yi; Sheu, Ching-Fan; Protas, Elizabeth. Construct validity and physical performance of older adults in different hierarchical physical-disability levels. JOURNAL OF AGING AND PHYSICAL ACTIVITY, 15. 1 (2007): 75-89. HUMAN KINETICS PUBL INC WRAY, L. A.; HERZOG, A. R.; WILLIS, R. J.; WALLACE, R. B. The impact of education and heart attack on smoking cessation among middle-aged adults. Journal of health and social behavior, 39. 4 (1998): 271-294. American Sociological Association Zamboni, M.; Mazzali, G.; Zoico, E.; Di Francesco, V.; et al. Health consequences of obesity in the elderly: A review of four unresolved questions. International Journal of Obesity, 29. 9 (2005): 1011-1029. Nature Publishing Group}, month = {2013 Sep}, pages = {1150-6}, publisher = {28}, abstract = {

BACKGROUND: Few longitudinal studies have examined associations between body mass index (BMI) changes in adults with diabetes and the development of disability.

OBJECTIVE: To investigate association patterns between BMI and disability in middle-aged adults with diabetes.

DESIGN AND SETTING: Retrospective cohort design with data from the 1992-2006 Health and Retirement Study (HRS). A group-based joint trajectory method identified distinct BMI change trajectories and their link to subsequent disability trajectories.

PARTICIPANTS: U.S. nationally representative adults aged 51-61 who reported a diagnosis of diabetes in the 1992 HRS (N = 1,064).

MEASUREMENTS: BMI and self-reported disability score were the main variables. Sociodemographic, clinical, behavioral, and diabetes-related factors were also examined.

RESULTS: Four distinct weight trajectories (stable normal weight, 28.7~\%; stable overweight, 46.2~\%; loss and regain obese, 18.0~\%; weight cumulating morbidly obese, 7.1~\%) and three disability trajectories (little or low increase, 34.4~\%; moderate increase, 45.4~\%; chronic high increase, 20.2~\%) best characterized the long-term patterns of BMI and disability change in middle-aged adults with diabetes. Adults in stable normal weight had the highest probability of being in the little/low increase disability group; however, one in five adults in that group progressed into chronic high disability, a higher proportion compared to the stable overweight group.

CONCLUSIONS: Although there were various ways in which the two trajectories were linked, the beneficial impacts of optimizing weight in adults with diabetes were supported. In addition, the complexity of diabetes control in those with relatively normal weight was highlighted from this study.

}, keywords = {Activities of Daily Living, Body Mass Index, Diabetes Mellitus, Type 2, Disability Evaluation, Disabled Persons, Female, Humans, Longitudinal Studies, Male, Middle Aged, Models, Statistical, Obesity, Obesity, Morbid, Overweight, Retrospective Studies, United States, Weight Gain, Weight Loss}, issn = {1525-1497}, doi = {10.1007/s11606-013-2399-z}, author = {Chiu, Ching-Ju and Linda A. Wray and Lu, Feng-hwa and Elizabeth A Beverly} }