Associations among self-reported diabetes, nutritional status, and socio-demographic variables in community-dwelling older adults
Keywords:
Aged, Diabetes mellitus, Nutritional statusAbstract
Objective
The aim of this study was to describe relationships between self-reported diabetes mellitus and its treatment, according to demographic and socioeconomic data, as well as indicators of nutritional status in community-dwelling older adults.
Methods
This is a population-based and a cross-sectional study derived from the multicentric survey “Frailty in Brazilian Elderly”. The random sample consisted of 881 community-dwelling older adults aged 65 years and older from the city of Campinas. The self-reported variables were: age, gender, family income (minimum salaries), education (years of education); and absolute data (yes versus no) regarding unintentional weight loss and weight gain, diabetes, and its treatment. Anthropometric variables were collected by trained examiners following classic protocols. Body mass index was classified as: underweight <23; normal weight ≥23 and <28; overweight ≥28 and <30; and obesity ≥30. Waist-to-hip ratio, indicator of abdominal adiposity, was classified according the
metabolic risk, for male and female, respectively: low 0.90-0.95 and 0.80-0.85; moderate 0.96-1.00 and 0.86-0.90; and high >1.00 and >0.90.
Results
The variables most associated with diabetes were obesity (OR=2.19), abdominal adiposity (OR=2.97), and unintentional weight loss (OR=3.38). The lack of diabetes treatment was associated with advanced age (p=0.027), lower educational level (p=0.005), and low metabolic risk (p=0.004).
Conclusion
Self-reported diabetes was associated with obesity but mostly with abdominal adiposity and unintentional weight loss. Not being treated for diabetes mellitus was associated with advanced age, lower levels of education, and lower abdominal adiposity.
References
Schmidt MI, Duncan BB, Silva GA, Menezes AM, Monteiro CA, Barreto SA, et al. Chronic noncommunicable diseases in Brazil: Burden and
current challenges. Lancet. 2011: 377(9781):1949-61. doi: 10.1016/S0140-6736(11)60437-6
World Health Organization. Definition and diagnosis of diabetes Mellitus and intermediate hyperglycemia: Report of a WHO/IDF consultation. Geneva: WHO; 2006.
Conwell LJ, Boult C. The effects of complications and comorbidities on the quality of preventive diabetes care: A literature review. Popul Health Manag. 2008; 11(4):217-28. doi: 10.1089/pop.20 07.0017
International Diabetes Federation. IDF Diabetes Atlas. 6th ed. Brussels: International Diabetes Federation; 2013 [cited 2014 Jun 10]. Available from: <http://www.idf.org/diabetesatlas>.
Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Vigitel Brasil 2011: vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico. Brasília: Ministério da Saúde; 2012.
Hu FB. Globalization of diabetes: The role of diet, lifestyle and genes. Diabetes Care. 2011; 34(6):1249-57. doi: 10.2337/dc11-0442
Kuk JL, Saunders TJ, Davidson LE, Ross R. Agerelated changes in total and regional fat distribution. Ageing Res Rev. 2009; 8(4):339-48. doi: 10.1016/j.arr.2009.06.001
Kaur J. A comprehensive review on metabolic syndrome. Cardiol Res Pract. 2014; 2014:943162. doi: 10.1155/2014/943162
Vazquez G, Duval S, Jacobs DR Jr., Silventoinen K. Comparison of body mass index, waist circumference and waist/hip ratio in predicting
incident diabetes: A meta-analysis. Epidemiol Rev. 2007; 29:115-28. doi: 10.1093/epirev/mxm008
Cheng CH, Ho CC, Yang CF, Huang YC, Lai CH, Liaw YP. Waist-to-hip ratio is a better anthropometric index than body mass index for predicting the risk of type 2 diabetes in Taiwanese population. Nutr Res. 2010; 30(9):585-93. doi: 10.1016/j.nutres.2010.08.007
Cervi A, Franceschini CC, Priore E, Federal U, Regional U, Grande R, et al. Critical analysis of the use of the body mass index for the elderly. Rev Nutr. 2005; 18(6):765-75. doi: 10.1590/S1415-5273 2005000600007
Instituto Brasileiro de Geografia e Estatística. Características étnico-raciais da população: um estudo das categorias de classificação de cor ou raça. Rio de Janeiro: IBGE; 2013 [cited 2013 Oct 11]. Available from: <http://www.ibge.gov.br/home/estatistica/populacao/caracteristicas_raciais/PCERP2008.pdf>.
Ferrucci L, Guralnik JM, Studenski S, Fried LP, Cutler GB Jr, Walston JD. Designing randomized, controlled trials aimed at preventing or delaying functional decline and disability in frail, older persons: A consensus report. J Am Geriatr Soc. 2004; 52(4):625-34. doi: 10.1111/j.1532-5415.2004.52174.x
Neri AL, Yassuda MS, Araújo LF, Eulálio MC, Cabral BE, Siqueira MEC, et al. Methodology and social, demographic, cognitive, and frailty profiles of community-dwelling elderly from seven Brazilian cities: The FIBRA study. Cad Saúde Pública. 2013; 29(4):778-92. doi: 10.1590/S0102-311X2013000800015
World Health Organization. Physical status: The use and interpretation of anthropometry. Report of a WHO Expert Committee. Geneva: World Health Organization; 1995 [cited 2012 Jun 5]. Available from: <http://whqlibdoc.who.int/trs/WHO_TRS_854.pdf?ua=1>.
Pan-American Health Organization. 36a Reunión del Comitê Asesor de Investigaciones en Salud - Encuesta Multicêntrica - Salud Bienestar y Envejecimiento (SABE) en América Latina y el Caribe: Informe preliminar; 2001 Jul 9-11, Kingston, Jamaica. Washington (DC): Pan-American Health Organization [acceso 2012 Jan 15]. Disponible en: <http://www.opas.org/program/sabe.htm>.
Lohman TG, Roche AF, Martorell R. Anthropometric standardization reference manual. Illinois: Human Kinetics Books; 1988.
Lebrão ML, Laurenti R. Health, well-being and aging: the SABE Study in São Paulo, Brazil. Rev Bras Epidemiol. 2005; 8(2):127-41. doi: 10.1590/S1415-790X2005000200005
Campino ACC, Cyrillo DC. Situação de ocupação e renda. In: Lebrão ML, Duarte YAO. O Projeto SABE no Município de São Paulo: uma abordagem inicial. Brasília: OPAS; 2003. p.241-55.
Francisco PMSB, Belon AP, Barros MBA, Carandina L, Alves MCGP, Goldbaum M, et al. Self-reported diabetes in the elderly: Prevalence, associated factors and control practices. Cad Saúde Pública. 2010; 26(1):175-84. doi: 10.1590/S0102-311X2010000100018
Wennberg AMV, Gottesman RF, Kaufmann CN, Albert MS, Chen-Edinboro LP, Rebok GW, et al. Diabetes and cognitive outcomes in a nationally representative sample: The National Health and Aging Trends Study. Int Psychogeriatr. 2014; 30:1-7.
Aurichio TR, Rebelatto JR, Castro AP. Obesity among older people of the City of São Carlos, SP, Brazil, and its association with diabetes Mellitus and joint pain. Fisioter Pesq. 2010; 17(2):114-7. doi: 10.1590/S1809-29502010000200004
Barros MBA, Francisco PMSB, Zanchetta LM, César CLG. Trends in social and demographic inequalities in the prevalence of chronic diseases in Brazil. PNAD: 2003-2008. Cienc Saúde Colet. 2011; 16(9):3755-68. doi: 10.1590/S1413-81232011001000012
Agardh E, Allebeck P, Hallqvist J, Moradi T, Sidorchuk A. Type 2 diabetes incidence and socioeconomic position: A systematic review and metaanalysis. Int J Epidemiol. 2011; 40(3):804-18. doi:10.1093/ije/dyr029
Marin MJS, Cecílio LCO, Perez AEWUF, Santella F, Silva CBA, Gonçalves Filho JR, et al. Use of medicines by the elderly in a Family Health Program unit in Brazil. Cad Saúde Pública. 2008; 24(7):1545-55. doi: 10.1590/S0102-311X2008000700009
Munshi MN, Maguchi M, Segal AR. Treatment of type 2 diabetes in the elderly. Curr Diab Rep. 2012; 12(3):139-45. doi: 10.1007/s11892-012-0269-4
Nascimento CM, Ribeiro AQ, Cotta RMM, Acurcio FA, Peixoto SV, Priore SE, et al. Nutritional status and associated factors among the elderly in Viçosa, Minas Gerais State, Brazil. Cad Saúde Pública. 2011; 27(12):2409-18. doi: 10.1590/S0102-311X2011001200012
Marucci MFN, Barbosa AR. Estado nutricional e capacidade física. In: Lebrão ML, Duarte YAO. O Projeto SABE no Município de São Paulo: uma abordagem inicial. Brasília: OPAS; 2003. p. 95-117.
Munaretti DB, Barbosa AR, Marucci MFN, Lebrão ML. Self-rated hypertension and anthropometric indicators of body fat in elderly. Rev Assoc Med Bras. 2011; 57(1):25-30. doi: 10.1590/S0104-42302011000100011
Benedetti TRB, Meurer ST, Morini S. Anthropometric indices related to cardiovascular and metabolic diseases in older adults. Rev Educ Fis UEM. 2012; 23(1):123-30. doi: 10.4025/reveducfis.v23i1.11393
Rodbard HW, Bays HE, Gavin JR, Green AJ, Bazata DD, Lewis SJ, et al. Rate and risk predictors for development of self-reported type-2 diabetes mellitus over a 5-year period: The SHIELD Study. Int J Clin Pract. 2012; 66(7):684-91. doi: 10.1111/j.1742-1241.2012.02952.x
Barzilay JI, Blaum C, Moore T, Xue QL, Hirsch CH, Walston JD, et al. Insulin resistance and inflammation as precursors of frailty: The
cardiovascular health study. Arch Intern Med. 2007; 167(7):635-41. doi: 10.1001/archinte.167.7.635
Goulet ED, Hassaine A, Dionne IJ, Gaudreau P, Khalil A, Fulop T, et al. Frailty in the elderly is associated with insulin resistance of glucose metabolism in the postabsorptive state only in the presence of increased abdominal fat. Exp Gerontol. 2009; 44(11):740-4. doi: 10.1016/j.exger.2009.08.008
Ahmed T, Haboubi N. Assessment and management of nutrition in older people and its importance to health. Clin Interv Aging. 2010; 5:207-16. doi: 10.2147/CIA.S9664
Murphy RA, Patel KV, Kritchevsky SB, Houston DK, Newman AB, Koster A, et al. Weight change, body composition, and risk of mobility disability and mortality in older adults: A population-based cohort study. J Am Geriatr Soc. 2014; 62(8):1476-83. doi: 10.1111/jgs.12954
Corona LP, Nunes DP, Alexandre TS, Santos JLF, Duarte YAO, Lebrão ML. Weight gain among elderly woman as risk fator for disability: Health, Well-Being and Aging Study (SABE Study). J Aging Health. 2013; 25(1):119-35. doi: 10.1177/0898264312466261
Cricelli C, Mazzaglia G, Samani F, Marchi M, Sabatini A, Nardi R, et al. Prevalence estimates for chronic diseases in Italy: Exploring the differences between self-report and primary care databases. J Public Health Med. 2003; 25(3):254-7. doi: 10.1093/pubmed/fdg060
Schneider ALC, Pankow JS, Heiss G, Selvin E. Validity and reliability of self-reported diabetes in the atherosclerosis risk in communities study. Am J Epidemiol. 2012; 176(8):738-43. doi: 10.1093/aje/kws156.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Maria Clara MORETTO, Maria Inês TADONI, Anita Liberalesso NERI Liberalesso NERI, Maria Elena GUARIENTO
This work is licensed under a Creative Commons Attribution 4.0 International License.