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

Andie MacNeil; Susanna Abraham Cottagiri; Paul J Villeneuve; Ying Jiang; Margaret de Groh; Esme Fuller-Thomson

doi:10.1016/j.jcjd.2024.02.005

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

Can J Diabetes. 2024 Apr 12:S1499-2671(24)00057-1. doi: 10.1016/j.jcjd.2024.02.005. Online ahead of print.

Authors

Andie MacNeil¹, Susanna Abraham Cottagiri², Paul J Villeneuve³, Ying Jiang⁴, Margaret de Groh⁴, Esme Fuller-Thomson⁵

Affiliations

¹ Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada; Institute for Life Course and Aging, University of Toronto, Toronto, Ontario, Canada.
² Department of Public Health Sciences, School of Medicine, Queens University, Kingston, Ontario, Canada.
³ Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada; CHAIM Research Centre, Carleton University, Ottawa, Ontario, Canada.
⁴ Applied Research Division, Center for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada.
⁵ Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada; Institute for Life Course and Aging, University of Toronto, Toronto, Ontario, Canada. Electronic address: esme.fuller.thomson@utoronto.ca.

PMID: 38639706
DOI: 10.1016/j.jcjd.2024.02.005

Abstract

Objectives: The objectives of this study were: 1) to examine and compare changes in functional limitations during the COVID-19 pandemic among older adults with and without diabetes; and 2): to identify key risk factors associated with developing functional limitations among older adults with and without diabetes during the pandemic.

Methods: We analyzed data collected from the Canadian Longitudinal Study on Aging. The analysis was restricted to those with no functional limitations in the follow-up 1 wave (2015 to 2018) (final sample N=6,045). Regression models were used to describe associations between diabetic status and functional limitation outcomes. We conducted stratified analyses to evaluate whether these associations varied by sociodemographic indicators. We also predicted the probability of the development of ≥1 functional limitation among those with and without diabetes for various patient profiles.

Results: Older adults with diabetes were 1.28-fold (95% confidence interval 1.02 to 1.60) more likely to develop ≥1 functional limitation than older adults without diabetes after controlling for relevant sociodemographic and health covariates. Risk factors for incident functional limitations among older adults, both with and without diabetes, include increasing age, low socioeconomic status, obesity, multimorbidity, and physical inactivity.

Conclusions: Our findings indicate that older adults with diabetes were at an increased risk of developing functional limitations during the pandemic when compared with older adults without diabetes, even when controlling for several key risk factors. Targetting modifiable risk factors, such as physical activity, may help to reduce the risk of functional limitations among older adults with diabetes.

Keywords: CLSA; COVID-19; Diabète; diabetes; functional limitations; limitations fonctionnelles; ÉLCV.