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Diabetes mellitus and gait dysfunction: possible explanatory factors.

TitleDiabetes mellitus and gait dysfunction: possible explanatory factors.
Publication TypeJournal Article
Year of Publication2008
AuthorsBrach, JS, Talkowski, JB, Strotmeyer, ES, Newman, AB
JournalPhys Ther
Volume88
Issue11
Pagination1365-74
Date Published2008 Nov
ISSN1538-6724
KeywordsAged, Body Mass Index, Cognition, Cross-Sectional Studies, Diabetes Mellitus, Female, Gait, Geriatric Assessment, Health Status, Humans, Linear Models, Longitudinal Studies, Male, Multicenter Studies as Topic, Muscle Strength
Abstract<p><b>BACKGROUND AND OBJECTIVE: </b>Gait characteristics differ in individuals with diabetes compared with those without diabetes. Limited information regarding potential explanatory factors for this association exists. This study examined the association between diabetes and gait characteristics in older adults and explored potential explanatory factors.</p><p><b>DESIGN: </b>A cross-sectional, observational study design was used.</p><p><b>METHODS: </b>At the 1998-1999 clinic visit, 558 ambulatory older adults (mean age=79 years) from the Pittsburgh site of the Cardiovascular Health Study had an assessment of their gait characteristics, diabetes, health status, cognition, mood, lower-extremity circulation and sensation, vision, lower-extremity strength (force-producing capacity), physical activity, and body mass index (BMI). A series of linear regression models were developed to examine the association between diabetes and gait characteristics and to examine potential explanatory factors for the associations.</p><p><b>RESULTS: </b>Diabetes was related to gait speed (beta=-.06 m/s); however, the association was partially explained by health status variables, cognition, mood, lower-extremity circulation and sensation, visual impairment, lower-extremity strength, physical activity, and BMI. Health status and lower-extremity strength each explained the greatest proportion of the association (beta reduced 66% by each). Diabetes was related to step width (beta=.02 m), and the association could not be explained by the examined factors.</p><p><b>CONCLUSIONS: </b>Diabetes was associated with gait alterations in older adults. Slowed gait speed appears to be secondary to the peripheral effect of the disease on other body systems. The effect of diabetes on step width was not explained in the analyses and may be related to peripheral motor nerve function or central influences of the disease, which could not be assessed in this study.</p>
DOI10.2522/ptj.20080016
Alternate JournalPhys Ther
PubMed ID18801861
PubMed Central IDPMC2579906
Grant ListP30 AG024827 / AG / NIA NIH HHS / United States
TG32AG00181 / AG / NIA NIH HHS / United States
N01-HC-85086 / HC / NHLBI NIH HHS / United States
N01-HC-15103 / HC / NHLBI NIH HHS / United States
N01-HC-35129 / HC / NHLBI NIH HHS / United States
N01-HC-55222 / HC / NHLBI NIH HHS / United States
N01-HC-75150 / HC / NHLBI NIH HHS / United States
1P30AG024827-01 / AG / NIA NIH HHS / United States
N01-HC-45133 / HC / NHLBI NIH HHS / United States
N01-HC-85079 / HC / NHLBI NIH HHS / United States
U01HL080295 / HL / NHLBI NIH HHS / United States
1K23AG026766-01 / AG / NIA NIH HHS / United States