Physical function limitations among middle-aged and older adults with prediabetes: one exercise prescription may not fit all

Abstract

Objective: To describe the prevalence of physical function limitations among a nationally representative sample of adults with prediabetes.

Research design and methods: We performed a cross-sectional analysis of 5,991 respondents≥53 years of age from the 2006 wave of the Health and Retirement Study. All respondents self-reported physical function limitations and comorbidities (chronic diseases and geriatric conditions). Respondents with prediabetes reported no diabetes and had a measured glycosylated hemoglobin (HbA1c) of 5.7-6.4%. Descriptive analyses and logistic regressions were used to compare respondents with prediabetes versus diabetes (diabetes history or HbA1c≥6.5%) or normoglycemia (no diabetes history and HbA1c<5.7%).

Results: Twenty-eight percent of respondents≥53 years of age had prediabetes; 32% had mobility limitations (walking several blocks and/or climbing a flight of stairs); 56% had lower-extremity limitations (getting up from a chair and/or stooping, kneeling, or crouching); and 33% had upper-extremity limitations (pushing or pulling heavy objects and/or lifting>10 lb). Respondents with diabetes had the highest prevalence of comorbidities and physical function limitations, followed by those with prediabetes, and then normoglycemia (P<0.05). Compared with respondents with normoglycemia, respondents with prediabetes had a higher odds of having functional limitations that affected mobility (odds ratio [OR] 1.48), the lower extremities (OR 1.35), and the upper extremities (OR 1.37) (all P<0.01). The higher odds of having lower-extremity limitations remained after adjusting for age, sex, and body mass index (OR 1.21, P<0.05).

Conclusions: Comorbidities and physical function limitations are prevalent among middle-aged and older adults with prediabetes. Effective lifestyle interventions to prevent diabetes must accommodate physical function limitations.

Figure 1

Flowchart of the respondents selected from the 2006 wave of the HRS. *Respondents not eligible for the enhanced face-to-face interview included 224 nursing home residents, 459 people who required proxy respondents, and 508 people interviewed by telephone only.

Figure 2

Prevalence of physical function limitations among U.S. adults ≥53 years of age with normoglycemia, prediabetes, and diabetes. Weighted percentages were derived with the use of HRS respondent population weights to adjust for differential probability of selection into the sample and differential nonresponse. P values are from χ² test for the association between the indicated variables and the three glycemic groups. SE bars are presented for each physical function. For all physical function items, P < 0.01 when comparing the three glycemic groups and prediabetes vs. diabetes. *P < 0.02 comparing respondents with prediabetes vs. normoglycemia.