The effect of diabetes combined with stroke on disability, self-rated health, and mortality in older Mexican Americans: Results from the Hispanic EPESE

Max E. Otiniano, Xianglin L. Du, Kenneth Ottenbacher, Kyriakos Markides

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54 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)725-730
Number of pages6
JournalArchives of Physical Medicine and Rehabilitation
Volume84
Issue number5
StatePublished - May 1 2003

Fingerprint

Activities of Daily Living
Hispanic Americans
Stroke
Mortality
Health
Confidence Intervals
Odds Ratio
Heart Neoplasms
Resource Allocation
Patient Discharge
Hip Fractures
Arthritis
Longitudinal Studies
Rehabilitation
Myocardial Infarction
Outcome Assessment (Health Care)
Hypertension
Morbidity

Keywords

  • Activities of daily living
  • Cerebrovascular accident
  • Diabetes mellitus
  • Mexican Americans
  • Rehabilitation

ASJC Scopus subject areas

  • Rehabilitation

Cite this

@article{72c2915611cc4bdd99d3203b3ac64553,
title = "The effect of diabetes combined with stroke on disability, self-rated health, and mortality in older Mexican Americans: Results from the Hispanic EPESE",
abstract = "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.",
keywords = "Activities of daily living, Cerebrovascular accident, Diabetes mellitus, Mexican Americans, Rehabilitation",
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TY - JOUR

T1 - The effect of diabetes combined with stroke on disability, self-rated health, and mortality in older Mexican Americans

T2 - Results from the Hispanic EPESE

AU - Otiniano, Max E.

AU - Du, Xianglin L.

AU - Ottenbacher, Kenneth

AU - Markides, Kyriakos

PY - 2003/5/1

Y1 - 2003/5/1

N2 - 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.

AB - 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.

KW - Activities of daily living

KW - Cerebrovascular accident

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KW - Rehabilitation

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