Diabetes predicts long-term disability in an elderly urban cohort

The Northern Manhattan Study

Mandip S. Dhamoon, Yeseon Park Moon, Myunghee C. Paik, Ralph L Sacco, Mitchell S V Elkind

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Purpose: There are limited data on vascular predictors of long-term disability in Hispanics. We hypothesized that (1) functional status declines over time and (2) vascular risk factors predict functional decline. Methods: The Northern Manhattan Study contains a population-based study of 3298 stroke-free individuals aged 40 years or older, followed for median 11 years. The Barthel Index (BI) was assessed annually. Generalized estimating equations and Cox models were adjusted for demographic, medical, and social risk factors. Stroke and myocardial infarction occurring during follow-up were censored in sensitivity analysis. Secondarily, motor and nonmotor domains of the BI were analyzed. Results: Mean age (standard deviation) of the cohort (n = 3298) was 69.2 (10) years, 37% were male, 52% Hispanic, 22% diabetic, and 74% hypertensive. There was a mean annual decline of 1.02 BI points (P < .0001). Predictors of decline in BI included age, female sex, diabetes, depression, and normocholesterolemia. Results did not change with censoring. We found similar predictors of BI for motor and nonmotor domains. Conclusion: In this large, population-based, multiethnic study with long-term follow-up, we found a 1% mean decline in function per year that did not change when vascular events were censored. Diabetes predicted functional decline in the absence of clinical vascular events.

Original languageEnglish
Pages (from-to)362-368
Number of pages7
JournalAnnals of Epidemiology
Volume24
Issue number5
DOIs
StatePublished - Jan 1 2014

Fingerprint

Blood Vessels
Hispanic Americans
Stroke
Proportional Hazards Models
Population
Myocardial Infarction
Demography
vascular factor

Keywords

  • Disability
  • Epidemiology
  • Stroke

ASJC Scopus subject areas

  • Epidemiology

Cite this

Diabetes predicts long-term disability in an elderly urban cohort : The Northern Manhattan Study. / Dhamoon, Mandip S.; Moon, Yeseon Park; Paik, Myunghee C.; Sacco, Ralph L; Elkind, Mitchell S V.

In: Annals of Epidemiology, Vol. 24, No. 5, 01.01.2014, p. 362-368.

Research output: Contribution to journalArticle

Dhamoon, Mandip S. ; Moon, Yeseon Park ; Paik, Myunghee C. ; Sacco, Ralph L ; Elkind, Mitchell S V. / Diabetes predicts long-term disability in an elderly urban cohort : The Northern Manhattan Study. In: Annals of Epidemiology. 2014 ; Vol. 24, No. 5. pp. 362-368.
@article{098fcc0b23294870bd5bec6fa631476c,
title = "Diabetes predicts long-term disability in an elderly urban cohort: The Northern Manhattan Study",
abstract = "Purpose: There are limited data on vascular predictors of long-term disability in Hispanics. We hypothesized that (1) functional status declines over time and (2) vascular risk factors predict functional decline. Methods: The Northern Manhattan Study contains a population-based study of 3298 stroke-free individuals aged 40 years or older, followed for median 11 years. The Barthel Index (BI) was assessed annually. Generalized estimating equations and Cox models were adjusted for demographic, medical, and social risk factors. Stroke and myocardial infarction occurring during follow-up were censored in sensitivity analysis. Secondarily, motor and nonmotor domains of the BI were analyzed. Results: Mean age (standard deviation) of the cohort (n = 3298) was 69.2 (10) years, 37{\%} were male, 52{\%} Hispanic, 22{\%} diabetic, and 74{\%} hypertensive. There was a mean annual decline of 1.02 BI points (P < .0001). Predictors of decline in BI included age, female sex, diabetes, depression, and normocholesterolemia. Results did not change with censoring. We found similar predictors of BI for motor and nonmotor domains. Conclusion: In this large, population-based, multiethnic study with long-term follow-up, we found a 1{\%} mean decline in function per year that did not change when vascular events were censored. Diabetes predicted functional decline in the absence of clinical vascular events.",
keywords = "Disability, Epidemiology, Stroke",
author = "Dhamoon, {Mandip S.} and Moon, {Yeseon Park} and Paik, {Myunghee C.} and Sacco, {Ralph L} and Elkind, {Mitchell S V}",
year = "2014",
month = "1",
day = "1",
doi = "10.1016/j.annepidem.2013.12.013",
language = "English",
volume = "24",
pages = "362--368",
journal = "Annals of Epidemiology",
issn = "1047-2797",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Diabetes predicts long-term disability in an elderly urban cohort

T2 - The Northern Manhattan Study

AU - Dhamoon, Mandip S.

AU - Moon, Yeseon Park

AU - Paik, Myunghee C.

AU - Sacco, Ralph L

AU - Elkind, Mitchell S V

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Purpose: There are limited data on vascular predictors of long-term disability in Hispanics. We hypothesized that (1) functional status declines over time and (2) vascular risk factors predict functional decline. Methods: The Northern Manhattan Study contains a population-based study of 3298 stroke-free individuals aged 40 years or older, followed for median 11 years. The Barthel Index (BI) was assessed annually. Generalized estimating equations and Cox models were adjusted for demographic, medical, and social risk factors. Stroke and myocardial infarction occurring during follow-up were censored in sensitivity analysis. Secondarily, motor and nonmotor domains of the BI were analyzed. Results: Mean age (standard deviation) of the cohort (n = 3298) was 69.2 (10) years, 37% were male, 52% Hispanic, 22% diabetic, and 74% hypertensive. There was a mean annual decline of 1.02 BI points (P < .0001). Predictors of decline in BI included age, female sex, diabetes, depression, and normocholesterolemia. Results did not change with censoring. We found similar predictors of BI for motor and nonmotor domains. Conclusion: In this large, population-based, multiethnic study with long-term follow-up, we found a 1% mean decline in function per year that did not change when vascular events were censored. Diabetes predicted functional decline in the absence of clinical vascular events.

AB - Purpose: There are limited data on vascular predictors of long-term disability in Hispanics. We hypothesized that (1) functional status declines over time and (2) vascular risk factors predict functional decline. Methods: The Northern Manhattan Study contains a population-based study of 3298 stroke-free individuals aged 40 years or older, followed for median 11 years. The Barthel Index (BI) was assessed annually. Generalized estimating equations and Cox models were adjusted for demographic, medical, and social risk factors. Stroke and myocardial infarction occurring during follow-up were censored in sensitivity analysis. Secondarily, motor and nonmotor domains of the BI were analyzed. Results: Mean age (standard deviation) of the cohort (n = 3298) was 69.2 (10) years, 37% were male, 52% Hispanic, 22% diabetic, and 74% hypertensive. There was a mean annual decline of 1.02 BI points (P < .0001). Predictors of decline in BI included age, female sex, diabetes, depression, and normocholesterolemia. Results did not change with censoring. We found similar predictors of BI for motor and nonmotor domains. Conclusion: In this large, population-based, multiethnic study with long-term follow-up, we found a 1% mean decline in function per year that did not change when vascular events were censored. Diabetes predicted functional decline in the absence of clinical vascular events.

KW - Disability

KW - Epidemiology

KW - Stroke

UR - http://www.scopus.com/inward/record.url?scp=84899970277&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84899970277&partnerID=8YFLogxK

U2 - 10.1016/j.annepidem.2013.12.013

DO - 10.1016/j.annepidem.2013.12.013

M3 - Article

VL - 24

SP - 362

EP - 368

JO - Annals of Epidemiology

JF - Annals of Epidemiology

SN - 1047-2797

IS - 5

ER -