Reported and measured physical functioning in older inner-city diabetic African Americans

Background. The impact of diabetes on disability and physical functioning i n older African Americans and potential causes of the excessive disability associated with diabetes in other studies have been inadequately investigat ed. Methods. A population-based survey was performed comparing 116 self-reporte d diabetic inner-city African Americans aged 70 years and older to 522 nond iabetic persons fr om the same population. A subsample (n = 168) received a physical examination focused on body habitus, upper and lower body strengt h, balance, and timed physical performance tasks. Blood tests were obtained from 173 subjects. Results. Diabetic individuals reported worse general health (p = .01), inst rumental activities of daily living (p = .02), and modified versions of the Rosow-Breslau scale (p < .001) and the Stanford Health Assessment Question naire (p = .002). Diabetic persons also reported more falls (0.59 per perso n vs 0.20, p = .019) and injurious falls (12% vs 6%, p = .025). There were minimal differences in the strength, balance, and timed performance measure s (analyzed separately by gender). In multi-variable analyses, impairments in Visual function and pain and light touch perception appeared to explain some of the association between diabetic status and poor general health, di sability, and falls, with lesser contribution From the number of medical pr oblems, number of medications, and glycemic control. Conclusions. Older inner-city diabetic blacks demonstrated worse general he alth, excess disability, and more falls compared to controls, although defi cits in strength, balance, and timed performance could not be demonstrated. The cause of decreased functional status in diabetic elders deserves addit ional investigation, focusing especially on sensory function, glycemic cont rol, and contribution from specific medical problems and medications.