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Epidemiology/Health Services Research
Combination of diabetes mellitus and lack of habitual physical activity is a risk factor for functional disability in Japanese
  1. Kazuya Fujihara1,
  2. Yasuhiro Matsubayashi1,
  3. Mayuko Harada Yamada1,
  4. Masaru Kitazawa1,
  5. Masahiko Yamamoto1,
  6. Masanori Kaneko1,
  7. Satoru Kodama1,
  8. Takuya Yahiro2,
  9. Ayumu Tsutsui2,
  10. Kiminori Kato1,
  11. Hirohito Sone1
  1. 1Department of Endocrinology and Metabolism, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
  2. 2Japan Medical Data Center Co., Ltd, Tokyo, Japan
  1. Correspondence to Dr Hirohito Sone; sone{at}med.niigata-u.ac.jp

Abstract

Objective Declining healthy life expectancy due to functional disability is relevant and urgent because of its association with decreased quality of life and also for its enormous socioeconomic impact. The aim of this study is to examine the impact of diabetes, hypertension, dyslipidemia and physical activity habits on functional disability among community-dwelling Japanese adults.

Research design and methods This is a population-based retrospective cohort study including 9673 people aged 39–98 years in Japan (4420, men). Functional disability was defined as a condition meeting Japan’s new long-term care insurance certification requirements for the need of assistance in the activities of daily living whether by caregivers or assistive devices. Cox proportional-hazards regression model identified variables related to functional disability.

Results Median follow-up was 3.7 years. During the study period, 165 disabilities occurred in the overall study population. Multivariate analysis showed that diabetes (HR 1.74 (95% CI 1.12 to 2.68)) and no physical activity habit (HR 1.83 (1.27 to 2.65)) presented increased risks for disability. HR for disability increased with the number of risk factors (HR of individuals with four conditions, 3.96 (1.59 to 9.99) vs individuals with none of those conditions as a reference). HR for disability among patients with diabetes with and without a physical activity habit was 1.68 (0.70 to 4.04) and 3.19 (1.79 to 5.70), respectively, compared with individuals without diabetes with a physical activity habit.

Conclusions The combination of diabetes and lack of habitual physical activity is predictive of functional disability in Japanese. Habitual physical activity attenuates the risk of functional disability in patients with diabetes.

  • disability
  • physical activity
  • body mass index
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjdrc-2019-000901

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    Footnotes

    • Contributors KF developed the study design, researched the data, contributed to discussions, wrote the manuscript, and reviewed and edited the manuscript. TY, AT and YM planned and supervised this research, researched the data, contributed to discussions, wrote the manuscript, and reviewed and edited the manuscript. YM, MY, MKi, MHY, MKa and SK researched the data, contributed to discussions, wrote the manuscript, and reviewed and edited the manuscript. KK researched the data and reviewed and edited the manuscript. HS developed the study design, contributed to discussions, and reviewed and edited the manuscript.

    • Funding This work is supported in part by the Japan Society for the Promotion of Science.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The Ethics Committee of the Niigata University approved this study (2015-2355).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement No data are available.