Associations among self-reported diabetes, nutritional status, and socio-demographic variables in community-dwelling older adults

Moretto, Maria Clara; Tadoni, Maria Inês; Neri, Anita Liberalesso; Guariento, Maria Elena

doi:10.1590/1415-52732014000600001

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Artigos Originais • Rev. Nutr. 27 (6) • Nov-Dec 2014 • https://doi.org/10.1590/1415-52732014000600001 copy

Associations among self-reported diabetes, nutritional status, and socio-demographic variables in community-dwelling older adults

Associações entre diabetes autorreferido, estado nutricional e variáveis sociodemográficas em idosos comunitários

Authorship SCIMAGO INSTITUTIONS RANKINGS

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.

Aged; Diabetes mellitus ; Nutritional status

Variables		n	%
Gender	Male	269	30.5
	Female	612	69.5
Age (years)	65-69	301	34.3
	70-74	281	31.9
	75-79	181	20.5
	≥80	118	13.4
Family income (minimum wages)	≤1.0	69	9.0
	1.1-3.0	306	39.9
	3.1-5.0	204	26.6
	5.1-10.0	126	16.4
	>10.0	61	8.0
Education	Never been to school	160	18.2
	1-4 years	478	54.4
	≥5 years	241	27.4
Self-reported diabetes	Yes	196	22.2
	No	685	77.8
Treatment for DM	Yes	173	90.1
	No	19	9.9
BMI	Underweight	136	15.5
	Normal weight	376	42.8
	Overweight	133	15.1
	Obesity	234	26.6
Weight loss	Yes	243	27.8
	No	631	72.2
Weight gain	Yes	182	27.0
	No	493	73.0
WHR (metabolic risk)	Low	325	37.0
	Moderate	237	27.0
	High	316	36.0

Variables and Categories	Self-reported diabetes					Treatment for DM
	Yes		No		p-value	Yes		No		p-value
	n	%	n	%		n	%	n	%
Gender
Male Female	62 134	31.6 68.4	207 478	30.2 69.8	0.705*	52 121	30.1 69.9	8 11	42.1 57.9	0.282**
Age (years)
65-69 70-74 75-79 ≥80	70 62 43 21	35.7 31.6 21.9 10.8	231 219 138 97	33.7 31.9 20.2 14.2	0.621*	64 57 37 15	37.0 32.9 21.4 8.7	5 3 5 6	26.3 15.8 26.3 31.6	0.027**
Family income (minimum salaries)
≤1.0 1.1-3.0 3.1-5.0 >5.0	18 73 42 38	10.5 42.7 24.6 22.2	51 233 162 149	08.6 39.2 27.2 25.0	0.623*	14 64 37 36	9.3 42.4 24.5 23.8	4 6 5 1	25.0 37.5 31.2 6.3	0.121**
Education
Never been to school 1-4 years ≥5 years	43 104 48	22.1 53.3 24.6	117 374 193	17.1 54.7 28.2	0.246*	31 96 45	18.0 55.8 26.2	10 7 2	52.6 36.9 10.5	0.005**
BMI
Underweight Normal weight Overweight Obesity	12 68 35 81	06.1 34.7 17.9 41.3	124 308 98 153	18.2 45.1 14.3 22.4	<0.001*	10 60 32 71	05.8 34.7 18.5 41.0	2 7 2 8	10.5 36.8 10.5 42.2	0.682**
Weight loss
Yes No	75 119	38.7 61.3	168 512	24.7 75.3	<0.001*	67 105	38.9 61.1	7 11	38.9 61.1	1.000**
Weight gain
Yes No	31 108	22.3 77.7	151 385	28.2 71.8	0.165*	25 98	20.3 79.7	3 10	23.1 76.9	0.730**
WHR
Low Moderate High	49 48 99	25.0 24.5 50.5	276 189 217	40.5 27.7 31.8	<0.001*	37 44 92	21.4 25.4 53.2	11 3 5	57.9 15.8 26.3	0.004**

Variables	Categories	p-value	OR*	95%CI OR*
Gender	Male (ref.)	-	1.00	-
	Female	0.705	0.93	0.66-1.32
Age (years)	65-69 (ref.)	-	1.00	-
	70-74	0.732	0.93	0.63-1.38
	75-79	0.900	1.03	0.66-1.59
	≥80	0.224	0.71	0.41-1.23
Family income (minimum salaries)	≤1.0	0.323	1.38	0.72-2.63
	1.1-3.0	0.362	1.23	0.78-1.91
	3.1-5.0	0.948	1.01	0.62-1.66
	>5.0 (ref.)	-	1.00	-
Education	Never been to school	0.104	1.48	0.92-2.36
	1-4 years	0.568	1.12	0.76-1.64
	≥5 years (ref.)	-	1.00	-
BMI	Underweight	0.013	0.44	0.23-0.84
	Normal weight (ref.)	-	1.00	-
	Overweight	0.043	1.62	1.01-2.58
	Obesity	0.000	2.40	1.64-3.49
Weight loss	Yes	0.000	1.92	1.37-2.69
	No (ref.)	-	1.00	-
Weight gain	Yes	0.166	0.73	0.47-1.14
	No (ref.)	-	1.00	-
WHR	Low (ref.)	-	1.00	-
	Moderate	0.110	1.43	0.92-2.22
	High	0.000	2.57	1.74-3.78

Variables	Categories	p-value	OR*	95%CI OR*
BMI	Underweight	0.399	0.71	0.32-1.56
	Normal weight (ref.)	-	1.00	-
	Overweight	0.070	1.75	0.95-3.21
	Obesity	0.003	2.19	1.29-3,70
WHR (metabolic risk)	Low (ref.)	-	1.00	-
	Moderate	0.099	1.67	0.90-3.08
	High	0.000	2.97	1.68-5.25
Weight loss	No (ref.)	-	1.00	-
	Yes	0.000	3.38	2.12-5.38

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[1] CONTRIBUTORS MC MORETTO, MI TADONI, AL NERI, and ME GUARIENTO contributed to project conception and design, and data analysis and interpretation. MC MORETTO and ME GUARIENTO participated in drafting the article and revising it critically for important intellectual content. AL NERI and ME GUARIENTO approved the final version to be published.