A Comparison of Higher-Level Functional Capacity Between Older Adults with and Without Type 2 Diabetes Mellitus: A Cross-Sectional Study Using Propensity Score Matching.

Abstract

Background/Objectives: In Japan, the number of older patients with diabetes mellitus (DM) is rapidly increasing; however, the impact of DM on higher-level functional capacity in this population is unclear. In this study, we aimed to clarify the characteristics of higher functional capacity in older patients with type 2 diabetes mellitus (T2DM). Methods: The participants included outpatients with T2DM receiving care at a general hospital and community-dwelling older adults without DM (both groups aged ≥ 65 years) in Japan. The Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) and the Japan Science and Technology Agency Index of Competence (JST-IC) were used to evaluate higher-level functional capacity. We compared the higher-level functional capacities of the two groups after propensity score matching to ensure homogeneity in background factors. Results: After propensity score matching, 131 individuals each from a group of older patients with T2DM and a group of community-dwelling older adults without DM were included (mean age: 76.6 ± 5.6 and 76.1 ± 5.4 years, respectively; male sex: 54.2% and 52.7%, respectively). The older patients with T2DM had higher average instrumental activities of daily living scores (4.8 vs. 4.6; p < 0.01) and lower average intellectual activity scores (3.4 vs. 3.8; p < 0.01) on the TMIG-IC, average JST-IC scores (10.3 vs. 11.6; p < 0.01), and average social engagement scores (1.0 vs. 2.2; p < 0.01) compared to the community-dwelling older adults without DM. Conclusions: Older outpatients with T2DM demonstrated poorer intellectual activity and social engagement than community-dwelling older adults without DM. Therefore, it may be necessary to focus on preventive interventions to support higher-level functional capacities in this population.