OBJECTIVE: To examine how diabetes in combination with stroke affects functional activities of daily living (ADLs) and instrumental activities of daily living (IADLs), self-rated health, and 5-year mortality in elderly Mexican Americans with or without other comorbid conditions. DESIGN: Longitudinal study. SETTING: Five southwestern states. PARTICIPANTS: A total of 3050 subjects of age 65 years or older, of whom 23% had diabetes and 6% had a stroke. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: ADL and IADL disabilities, self-rated health, and 5-year mortality. RESULTS: Subjects with both diabetes and stroke but without other comorbid conditions had almost 18 times higher risk of having any ADL disability (odds ratio [OR]=18.8; 95% confidence interval [CI], 3.3-105.2) and 10 times higher risk of having any IADL disability (OR=10.6; 95% CI, 1.1-101.5), compared with subjects without either of the 2 conditions. The risk of disability was further increased if the subject had a comorbid condition (hypertension, heart attack, cancer, hip fracture, arthritis). The risk of fair or poor self-rated health was 3.5 (95% CI, 1.4-8.6) and the hazard ratio for 5-year mortality was 2.4 (95% CI, 1.7-3.4) in people with both diseases. CONCLUSIONS: Diabetes and stroke in combination is strongly associated with a higher risk of disabilities, poor self-rated health, and 5-year mortality in elderly Mexican Americans. The effect on outcomes appears to follow an additive model. Information on disability risk and morbidity and mortality should be useful to rehabilitation professionals in discharge planning and allocation of therapy resources.
OBJECTIVE: To examine how diabetes in combination with stroke affects functional activities of daily living (ADLs) and instrumental activities of daily living (IADLs), self-rated health, and 5-year mortality in elderly Mexican Americans with or without other comorbid conditions. DESIGN: Longitudinal study. SETTING: Five southwestern states. PARTICIPANTS: A total of 3050 subjects of age 65 years or older, of whom 23% had diabetes and 6% had a stroke. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: ADL and IADL disabilities, self-rated health, and 5-year mortality. RESULTS: Subjects with both diabetes and stroke but without other comorbid conditions had almost 18 times higher risk of having any ADL disability (odds ratio [OR]=18.8; 95% confidence interval [CI], 3.3-105.2) and 10 times higher risk of having any IADL disability (OR=10.6; 95% CI, 1.1-101.5), compared with subjects without either of the 2 conditions. The risk of disability was further increased if the subject had a comorbid condition (hypertension, heart attack, cancer, hip fracture, arthritis). The risk of fair or poor self-rated health was 3.5 (95% CI, 1.4-8.6) and the hazard ratio for 5-year mortality was 2.4 (95% CI, 1.7-3.4) in people with both diseases. CONCLUSIONS:Diabetes and stroke in combination is strongly associated with a higher risk of disabilities, poor self-rated health, and 5-year mortality in elderly Mexican Americans. The effect on outcomes appears to follow an additive model. Information on disability risk and morbidity and mortality should be useful to rehabilitation professionals in discharge planning and allocation of therapy resources.
Authors: Bret T Howrey; Soham Al Snih; Kyu K Jana; Mary Kristen Peek; Kenneth J Ottenbacher Journal: J Gerontol A Biol Sci Med Sci Date: 2015-10-07 Impact factor: 6.053
Authors: Emanuele Di Angelantonio; Stephen Kaptoge; David Wormser; Peter Willeit; Adam S Butterworth; Narinder Bansal; Linda M O'Keeffe; Pei Gao; Angela M Wood; Stephen Burgess; Daniel F Freitag; Lisa Pennells; Sanne A Peters; Carole L Hart; Lise Lund Håheim; Richard F Gillum; Børge G Nordestgaard; Bruce M Psaty; Bu B Yeap; Matthew W Knuiman; Paul J Nietert; Jussi Kauhanen; Jukka T Salonen; Lewis H Kuller; Leon A Simons; Yvonne T van der Schouw; Elizabeth Barrett-Connor; Randi Selmer; Carlos J Crespo; Beatriz Rodriguez; W M Monique Verschuren; Veikko Salomaa; Kurt Svärdsudd; Pim van der Harst; Cecilia Björkelund; Lars Wilhelmsen; Robert B Wallace; Hermann Brenner; Philippe Amouyel; Elizabeth L M Barr; Hiroyasu Iso; Altan Onat; Maurizio Trevisan; Ralph B D'Agostino; Cyrus Cooper; Maryam Kavousi; Lennart Welin; Ronan Roussel; Frank B Hu; Shinichi Sato; Karina W Davidson; Barbara V Howard; Maarten J G Leening; Maarten Leening; Annika Rosengren; Marcus Dörr; Dorly J H Deeg; Stefan Kiechl; Coen D A Stehouwer; Aulikki Nissinen; Simona Giampaoli; Chiara Donfrancesco; Daan Kromhout; Jackie F Price; Annette Peters; Tom W Meade; Edoardo Casiglia; Debbie A Lawlor; John Gallacher; Dorothea Nagel; Oscar H Franco; Gerd Assmann; Gilles R Dagenais; J Wouter Jukema; Johan Sundström; Mark Woodward; Eric J Brunner; Kay-Tee Khaw; Nicholas J Wareham; Eric A Whitsel; Inger Njølstad; Bo Hedblad; Sylvia Wassertheil-Smoller; Gunnar Engström; Wayne D Rosamond; Elizabeth Selvin; Naveed Sattar; Simon G Thompson; John Danesh Journal: JAMA Date: 2015-07-07 Impact factor: 56.272
Authors: Soham Al Snih; Michielle N Fisher; Mukaila A Raji; Kyriakos S Markides; Glenn V Ostir; James S Goodwin Journal: J Gerontol A Biol Sci Med Sci Date: 2005-09 Impact factor: 6.053
Authors: James E Graham; Cynthia M Ripsin; Anne Deutsch; Yong-Fang Kuo; Sam Markello; Carl V Granger; Kenneth J Ottenbacher Journal: Arch Phys Med Rehabil Date: 2009-07 Impact factor: 3.966