nach oben

Current Diabetes Reports

Erschienen in:

01.12.2013 | Diabetes Epidemiology (SH Golden, Section Editor)

Physical Disability in the Elderly with Diabetes: Epidemiology and Mechanisms

verfasst von: Lara Bianchi, Giovanni Zuliani, Stefano Volpato

Erschienen in: Current Diabetes Reports | Ausgabe 6/2013

Einloggen, um Zugang zu erhalten

Abstract

Diabetes mellitus is a common chronic condition worldwide, especially in the elderly population. Several epidemiologic studies in the last 2 years have consistently associated diabetes with physical disability, a condition that may profoundly affect the quality of life of older people. Although in older people with diabetes, the pathogenesis of functional limitation and disability has not been completely elucidated, it is certainly complex and involves multiple potential pathways. In this narrative review, we described the most recent epidemiologic and clinical evidence supporting the association between diabetes and impaired physical function in older persons focusing on emerging biological mechanisms explaining the excess risk of disability associated with diabetes.

International Diabetes Federation (IDF). The Global Burden: Diabetes. Available at: http://www.idf.org/diabetesatlas/5e/Update2012. Accessed April 30, 2013.

•• Volpato S, Maraldi C, Fellin R. Type 2 diabetes and risk for functional decline and disability in older persons. Curr Diabetes Rev. 2010;6:134–43. An exhaustive review defining the nature of the relationship between diabetes and physical disability. PubMedCrossRef

Fried LP, Guralnik JM. Disability in older adults: evidence regarding significance, etiology and risk. J Am Geriatr Soc. 1997;45:92–100.PubMed

U.S. Centers for Disease Control and Prevention. Diabetes data & trends: percentage by age of civilian, noninstitutionalized persons with diagnosed diabetes, United States, 1980–2011. Available at: http://www.cdc.gov/diabetes/statistics/prev/national/figbyage.html. Accessed April 30, 2013.

• Economic costs of diabetes in the U.S. in 2012. American Diabetes Association. Diabetes Care. 2013;36:1033–46. This paper estimates the economic impact of diabetes in the U.S. CrossRef

Boyle JP, Thompson TJ, Gregg EW, Barker LE, Williamson DF. Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence. Population Health Metrics. 2010;22:8–29.

Shaw J, Zimmet P, de Courten M, Dowse G, Chitson P, Gareeboo H, et al. Impaired fasting glucose or impaired glucose tolerance. What best predicts future diabetes in Mauritius? Diabetes Care. 1999;22:399–402.PubMedCrossRef

Hiltunen LA. Does glucose tolerance affect elderly persons’ balance, gait or muscle strength? Cent Eur J Public Health. 2001;9:22–5.PubMed

Verbrugge LM, Jette AM. The disablement process. Soc Sci Med. 1994;38:1–14.PubMedCrossRef

10.

Guralnik JM, Ferrucci L. Assessing the building blocks of function: utilizing measures of functional limitation. Am J Prev Med. 2003;25:112–21.PubMedCrossRef

11.

Chiu CJ, Wray LA. Physical disability trajectories in older Americans with and without diabetes: the role of age, gender, race or ethnicity, and education. Gerontologist. 2011;51:51–63.PubMedCrossRef

12.

•• Volpato S, Bianchi L, Lauretani F, et al. Role of muscle mass and muscle quality in the association between diabetes and gait speed. Diabetes Care. 2012;35:1672–9. This study found that older people with diabetes have higher muscle mass, lower muscle strength, worse muscle quality, and slower gait speed compared with participants without diabetes. PubMedCrossRef

13.

Izerman TH, Schaper NC, Melai T, Meijer K, Willems PJ, Savelberg HH. Lower extremity muscle strength is reduced in people with type 2 diabetes, with and without polyneuropathy, and is associated with impaired mobility and reduced quality of life. Diabetes Res Clin Pract. 2012;95:345–51.CrossRef

14.

Kalyani RR, Tra Y, Yeh HC, Egan JM, Ferrucci L, Brancati FL. Quadriceps strength, quadriceps power, and gait speed in older U.S. adults with diabetes mellitus: results from the National Health and Nutrition Examination Survey, 1999–2002. J Am Geriatr Soc. 2013. [Epub ahead of print].

15.

Leenders M, Verdijk LB, van der Hoeven L, Adam JJ, van Kranenburg J, Nilwik R, et al. Patients with type 2 diabetes show a greater decline in muscle mass, muscle strength, and functional capacity with aging. J Am Med Dir Assoc. 2013 [Epub ahead of print].

16.

Guralnik JM, LaCroix AZ, Abbott RD, et al. Maintaining mobility in late life. I. Demographic characteristics and chronic conditions. Am J Epidemiol. 1993;137:845–57.PubMed

17.

Gregg EW, Mangione CM, Cauley JA, et al. Diabetes and incidence of functional disability in older women. Diabetes Care. 2002;25:61–7.PubMedCrossRef

18.

Andrade FC, Guevara PE, Lebrão ML, Duarte YA. Correlates of the incidence of disability and mortality among older adult Brazilians with and without diabetes mellitus and stroke. BMC Publ Health. 2012;12:361.CrossRef

19.

Volpato S, Blaum C, Resnick H, Ferrucci L, Fried LP, Guralnik JM. Comorbidities and impairments explaining the association between diabetes and lower extremity disability: the women's health and aging study. Diabetes Care. 2002;25:678–83.PubMedCrossRef

20.

UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet. 1998;352:854–65. Erratum, Lancet 1998;352:1558.CrossRef

21.

Huang ES, Zhang Q, Gandra N, Chin MH, Meltzer DO. The effect of comorbid illness and functional status on the expected benefits of intensive glucose control in older patients with type 2 diabetes: a decision analysis. Ann Intern Med. 2008;149:11–9.PubMedCrossRef

22.

• Kalyani RR, Tian J, Xue QL, Walston J, Cappola AR, Fried LP, et al. Hyperglycemia and incidence of frailty and lower extremity mobility limitations in older women. J Am Geriatr Soc. 2012;60:1701–7. This paper clearly demonstrates that higher levels of glycated hemoglobin are associated with development of poor physical performance.PubMedCrossRef

23.

Wang CP, Hazuda HP. Better glycemic control is associated with maintenance of lower-extremity function over time. Diabetes Care. 2011;34:268–73.PubMedCrossRef

24.

• Yau CK, Eng C, Cenzer IS, Boscardin WJ, Rice-Trumble K, et al. Glycosylated hemoglobin and functional decline in community-dwelling nursing home–eligible elderly adults with diabetes mellitus. J Am Geriatr Soc. 2012;60:1215–21. This paper introduced a controversy regarding the effects of pursuing very low glucose levels in older diabetic patients. PubMedCrossRef

25.

Schwartz AV, Vittinghoff E, Sellmeyer DE, et al. Diabetes-related complications, glycemic control, and falls in older adults. Diabetes Care. 2008;31:391–6.PubMedCrossRef

26.

Launer LJ, Miller ME, Williamson JD, Lazar RM, Gerstein HC, Murray AM, et al. ACCORD MIND investigators. Effects of intensive glucose lowering on brain structure and function in people with type 2 diabetes (ACCORD MIND): a randomized open-label substudy. Lancet Neurol. 2011;10:969–77.PubMedCrossRef

27.

Gerstein HC, Miller ME, Byington RP, Goff Jr DC, Bigger JT, Buse JB, et al. Action to control cardiovascular risk in diabetes study group, Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008;358:2545–59.PubMedCrossRef

28.

Brown AF, Mangione CM, Saliba D, et al. Guidelines for improving the care of the older person with diabetes mellitus. J Am Geriatr Soc. 2003;5(Suppl Guidelines):265–80.

29.

• Fielding R, Vellas B, Evans W, et al. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International Working Group on Sarcopenia. J Am Med Dir Assoc. 2011;12:249–56. This paper provides new data on the definition, prevalence, etiology, and consequences of Sarcopenia. PubMedCrossRef

30.

•• Park SW, Goodpaster BH, Lee JS, et al. Health, aging, and body composition study. Excessive loss of skeletal muscle mass in older adults with type 2 diabetes. Diabetes Care. 2009;1993–7. This is one of the first papers in which type 2 diabetes has been associated with excessive loss of skeletal muscle mass in community-dwelling older adults overtime.

31.

Martinelli AR, Mantovani AM, Nozabieli AJ, Ferreira DM, Barela JA, Camargo MR, et al. Muscle strength and ankle mobility for the gait parameters in diabetic neuropathies. Foot. 2013;23:317–21.CrossRef

32.

McDermott MM, Guralnik JM, Albay M, Bandinelli S, Miniati B, Ferrucci L. Impairments of muscles and nerves associated with peripheral arterial disease and their relationship with lower extremity functioning: the InCHIANTI study. J Am Geriatr Soc. 2004;52:405–10.PubMedCrossRef

33.

Miljkovic-Gacic I, Wang X, Kammerer CM, Gordon CL, Bunker CH, Kuller LH, et al. Fat infiltration in muscle: new evidence for familial clustering and associations with diabetes. Obesity. 2008;16:1854–60.PubMedCrossRef

34.

Visser M, Goodpaster BH, Kritchevsky SB, Newman AB, Nevitt M, Rubin SM, et al. Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons. J Gerontol A Biol Sci Med Sci. 2005;60:324–33.PubMedCrossRef

35.

Badawi A, Klip A, Haddad P, Cole DE, Bailo BG, El-Sohey A, et al. Type 2 diabetes mellitus and inflammation: prospects for biomarkers of risk and nutritional intervention. Diabetes Metab Syndr Obes. 2010;3:173–86.PubMedCrossRef

36.

Kuo HK, Al Snih S, Kuo YF, Raji MA. Cross-sectional associations of albuminuria and C-reactive protein with functional disability in older adults with diabetes. Diabetes Care. 2011;34:710–7.PubMedCrossRef

37.

Palmer RF, Espino DV, Dergance JM, Becho J, Markides K. The role of physical activity and diabetes status as a moderator: functional disability among older Mexican Americans. Age Ageing. 2012;41:752–8.PubMedCrossRef

38.

• Rejeski WJ, Ip EH, Bertoni AG, Bray GA, Evans G, Gregg EW, et al. Look AHEAD Research Group. Lifestyle change and mobility in obese adults with type 2 diabetes. N Engl J Med. 2012;366:1209–17. An important outcome paper from Look AHEAD showing that lifestyle intervention appears to impact the loss of mobility in people with type 2 diabetes. PubMedCrossRef

39.

Umpierre D, Ribeiro PA, Kramer CK, Leitão CB, Zucatti AT, Azevedo MJ, et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA. 2011;305:1790–9.PubMedCrossRef

40.

Fagour C, Gonzalez C, Pezzino S, Florenty S, Rosette-Narece M, Gin H, et al. Low physical activity in patients with type 2 diabetes: the role of obesity. Diabetes & Metabolism. 2013;39:85–7.CrossRef

41.

Cesari M, Penninx BW, Pahor M, Lauretani F, Corsi AM, Williams GR, et al. Inflammatory markers and physical performance in older persons: the InCHIANTI Study. J Gerontol. 2004;59:242–8.CrossRef

42.

Libby P, Ridker PM, Hansson GK. Leducq Transatlantic Network on atherothrombosis. Inflammation in atherosclerosis: from pathophysiology to practice. J Am Coll Cardiol. 2009;54:2129–38.PubMedCrossRef

43.

Pugh KG, Lipsitz LA. The microvascular frontal-subcortical syndrome of aging. Neurobiol Aging. 2002;23:421–31.PubMedCrossRef

44.

Maraldi C, Volpato S, Penninx BW, Yaffe K, Simonsick EM, Strotmeyer ES, et al. Diabetes mellitus, glycemic control, and incident depressive symptoms among 70- to 79-year-old persons: the health, aging, and body composition study. Arch Intern Med. 2007;167:1137–44.PubMedCrossRef

45.

Cheng G, Huang C, Deng H, Wang H. Diabetes as a risk factor for dementia and mild cognitive impairment: a meta-analysis of longitudinal studies. Intern Med J. 2012;42:484–91.PubMedCrossRef

46.

Nouwen A, Winkley K, Twisk J, Lloyd CE, Peyrot M, Ismail K, et al. European Depression in Diabetes (EDID) Research Consortium. Type 2 diabetes mellitus as a risk factor for the onset of depression: a systematic review and meta-analysis. Diabetologia. 2010;53:2480–6.PubMedCrossRef

47.

Malhotra C, Chan A, Malhotra R, Ostbye T. Prevalence, correlates and perceived causes of limitations in activities of daily living among older Singaporeans. Aging Clin Exp Res. 2012;24:56–61.PubMedCrossRef

48.

Dybicz SB, Thompson S, Molotsky S, Stuart B. Prevalence of diabetes and the burden of comorbid conditions among elderly nursing home residents. Am J Geriatr Pharmacother. 2011;9:212–23.PubMedCrossRef

49.

Chiu CJ, Wray LA, Ofstedal MB. Diabetes-related change in physical disability from midlife to older adulthood: evidence from 1996–2003. Survey of health and living status of the elderly in Taiwan. Diabetes Res Clin Pract. 2011;91:413–23.PubMedCrossRef

50.

Martinez-Huedo MA, Hernandez-Barrera V, Palacios-Ceña D, Carrasco-Garrido P, Hernandez DM, Jiménez-Garcia R. Trends in the prevalence of physical and functional disability among Spanish elderly suffering from diabetes (2000–2007). Diabetes Res Clin Pract. 2011;94:30–3.CrossRef

51.

Chau PH, Woo J, Lee CH, et al. Older people with diabetes have higher risk of depression, cognitive and functional impairments: implications for diabetes services. J Nutrit Health Aging. 2011;15:751–5.CrossRef

Titel: Physical Disability in the Elderly with Diabetes: Epidemiology and Mechanisms
verfasst von: Lara Bianchi
Giovanni Zuliani
Stefano Volpato
Publikationsdatum: 01.12.2013
Verlag: Springer US
Erschienen in: Current Diabetes Reports / Ausgabe 6/2013
Print ISSN: 1534-4827
Elektronische ISSN: 1539-0829
DOI: https://doi.org/10.1007/s11892-013-0424-6

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2013

Moving on from GWAS: Functional Studies on the G6PC2 Gene Implicated in the Regulation of Fasting Blood Glucose

Positive Psychological Characteristics in Diabetes: A Review

The Growing Prevalence of Type 2 Diabetes: Increased Incidence or Improved Survival?

Social Epidemiology of Diabetes and Associated Conditions

Eating Disorders and Disordered Eating in Type 1 Diabetes: Prevalence, Screening, and Treatment Options