Diabetes, race, and functional limitations in older U.S. men and women

- Black men are more likely to have mobility limitations than White men with or without diabetes.
- Black women are more likely to have mobility limitations than White women without diabetes.
- For women, there are no differences in mobility limitations by race with diabetes.
- Limitations in leisure and social activities are more common in Black men with diabetes.
- Limitations in general physical activities are less common in Black women with diabetes.

AimsThe presence of diabetes is associated with increased odds of difficulties in functional tasks but it remains unclear if the burden is similar by race.MethodsOur study included 122,004 non-Hispanic Black (NHB) and non-Hispanic White (NHW) adults ≥50 years from the U.S. National Health Interview Survey (2001-2012). Diabetes was defined as self-reported diagnosis or medication use. Functional limitations were defined as any self-reported difficulty in performing mobility tasks, general physical activities (GPA), or leisure and social activities (LSA). Logistic regression models were created to investigate the relationship of race with functional limitations accounting for key covariates, among men and women, by diabetes status.ResultsAmong older U.S. adults, NHB versus NHW women without diabetes had a higher odds of limitations in mobility (OR = 1.39, 1.30-1.49) and LSA (OR = 1.13, 1.05-1.23) without diabetes but a similar odds of these limitations with diabetes by race, after adjusting for age, income, education, obesity, arthritis, heart disease, stroke, COPD, and cancer. Interestingly, NHB versus NHW women had significantly lower odds of GPA, irrespective of diabetes status. However, NHB versus NHW men with diabetes had a persistently higher odds for mobility and LSA limitations with diabetes as follows: mobility (OR = 1.30, 1.12-1.51) and LSA limitations (OR = 1.07, 1.06-1.34). The interaction of race and diabetes was significant among women for mobility limitations (p < 0.01), but not men.ConclusionsThe burden of functional limitations differs by race among both men and women with diabetes. Future studies should examine mechanisms underlying these differences to prevent progression to disability in older adults with diabetes.