Physical disability among older Italians with diabetes. The ILSA Study

AIMS/HYPOTHESIS: We studied the role of diabetic complications and comorbidity in the association between diabetes and disability in the elderly. METHODS: Data were from a nationally representative sample of 5632 older Italians, aged 65 years and older, and who participated in the Italian Longitudinal Study on Aging. Clinical diagnoses of diabetes and other major chronic conditions were made by a physician, while disability was assessed by self-reported information on activities of daily living and physical performance tests. RESULTS: After adjusting for age, education and BMI, disability on the basis of activities of daily living was associated with diabetes in women, but not in men (odds ratio [OR] 1.65, CI: 1.22-2.23 and OR 1.21, CI: 0.84-1.75 respectively). In contrast, the association between severe and/or total disability on the basis of physical performance tests and diabetes was strong in both sexes (OR 2.81, CI: 1.44-5.41 and OR 2.16, CI: 1.25-3.73 respectively). Adjusting for traditional complications and comorbidity reduced the excess odds of disability by 38% in women and by 16% in men. CONCLUSIONS/INTERPRETATION: Disability in older Italians with diabetes is frequent and only partially attributable to traditional diabetic complications and comorbidity.