Background. Older persons with type 2 diabetes are at higher risk for funct
ional impairment than are their age-matched counterparts without diabetes.
We therefore sought to identify factors associated with impaired physical f
unction in older persons with type 2 diabetes by using a cross-sectional st
udy design.
Methods. We studied 1238 persons with type 2 diabetes who were 55 years of
age or older and enrolled in die Type II Diabetes Patient Outcomes Research
Team (PORT) project. Subjects were primary care patients at a large staff
model health maintenance organization who had completed a mailed survey tha
t collected information about demographics (age, race, marital status, inco
me, education, gender, and body mass index [BMI]), health behaviors (exerci
se, smoking, and alcohol), care and control of diabetes (therapy, self-repo
rted glucose control, home glucose monitoring. and disease duration), mood
(Center for Epidemiologic Studies-Depression Scale ICES-DI), comorbidity, a
nd the Short-Form-36 health survey (SF-36).
We evaluated the bivariate relationships between the PFI-10 a 10-item measu
re of physical function from the SP-36, and candidate independent variables
from the domains described previously. Variables that were significant at
an a level of .10 were entered into a multiple linear regression model.
Results. There were eight independent predictors of impaired physical funct
ion (all p < .05, R-2 = .40). Factors associated with impaired function in
order of their relative importance were as follows: a higher comorbidity sc
ore, older age, obesity, lack of regular exercise, CES-D score higher than
20, taking insulin, lower formal education, and abstinence from alcohol.
Conclusions. Increased comorbidity and older age are associated with poorer
function, as is the severity of diabetes and less formal education. Exerci
se, lower BMI, and better mood are associated with better function. Therefo
re, promoting regular exercise and weight loss, in addition to treating dep
ression, are likely to preserve or even improve the functional status of ol
der persons with type 2 diabetes. Moderate alcohol use may be beneficial as
well. The extent to which these relationships persist in prospective studi
es or clinical trials remains to be evaluated.