During the COVID-19 pandemic, researchers discovered that around one in five older Canadian adults with diabetes who previously had no functional limitations developed such limitations for the first time. Functional limitations encompass difficulties with basic mobility tasks like walking a few blocks, rising from a chair, or ascending stairs. In contrast, only one in eight older adults without diabetes encountered new functional limitations during the same period.
Functional status, a critical predictor of both longevity and quality of life in older populations, tends to deteriorate more rapidly in individuals with diabetes compared to those without. Andie MacNeil, the lead author and a research assistant at the University of Toronto’s Factor-Inwentash Faculty of Social Work and the Institute for Life Course and Aging, noted that the pandemic intensified various risk factors associated with functional decline, including social isolation and reduced physical activity. This led the research team to probe how the pandemic affected the functional status of older adults with diabetes.
The data for the study was drawn from the Canadian Longitudinal Study on Aging, which revealed that older adults with diabetes were 53% more likely to develop at least one new functional limitation during the pandemic than their non-diabetic counterparts. This was after accounting for major functional decline risk factors such as physical activity, obesity, smoking, and other chronic conditions. Still, those with diabetes had a 28% greater risk of functional decline.
Health professionals are encouraged by the findings to promote engagement in physical activity among older adults, particularly those with diabetes, to help maintain their functional status, as suggested by Susanna Abraham Cottagiri, a doctoral candidate at the School of Medicine at Queen’s University.
Significantly, the study underscored the influence of socioeconomic factors on the likelihood of developing functional limitations. Older adults with diabetes earning less than $20,000 annually were found to be at a fivefold higher risk of developing functional limitations compared to those earning over $100,000. Even for those without diabetes, the risk was doubled under similar economic conditions. This finding, reiterated by Ying Jiang, a senior epidemiologist at the Public Health Agency of Canada and co-author of the study, emphasizes the need for targeted interventions to address socioeconomic disparities in functional decline.
The researchers also examined how functional limitations varied across different patient characteristics, including sex, diabetes status, and household income, considering various risk factors such as age, physical activity, smoking, multimorbidity, and body weight. Socioeconomic status consistently emerged as a significant determinant of functional health across these profiles.
Professor Paul Villeneuve of Carleton University’s Department of Neuroscience and the CHAIM Research Centre posited that lower socioeconomic status might lead to more significant lifetime stressors that can negatively affect life’s physical functioning. Such stressors include more physically demanding jobs, poorer nutrition, and living in environments with fewer green spaces and lower walkability.
The study’s implications are significant, offering potential strategies to enhance physical function in middle-aged and older adults. Margaret de Groh, a co-author and scientific manager at the Public Health Agency of Canada, emphasized the benefits of a comprehensive approach. This includes lifestyle modifications involving physical activity and nutritional interventions, which have shown promise in improving physical function among older adults with diabetes.
Professor Esme Fuller-Thomson, the senior author and director of the Institute for Life Course & Aging at the University of Toronto, also pointed out that poverty remains a significant obstacle to nutrition and food security. She advocated for broader strategies to reduce poverty and improve food access in Canada to support better physical functioning among older adults. These comprehensive approaches can help mitigate the adverse effects of diabetes on older adults, potentially leading to improved quality of life and extended longevity for this vulnerable population.
More information: Andie MacNeil et al, Incident Functional Limitations Among Older Adults With Diabetes During the COVID-19 Pandemic: An Analysis of Prospective Data From the Canadian Longitudinal Study on Aging, Canadian Journal of Diabetes. DOI: 10.1016/j.jcjd.2024.02.005
Journal information: Canadian Journal of Diabetes Provided by University of Toronto
