Functional limitations of upper limbs in older diabetic individuals. The Italian Longitudinal Study on Aging

Abstract

Background and aims: This study aimed at assessing the prevalence rate of symptoms of shoulder osteoarthritis in diabetic subjects and their possible associations, as part of the prospective study called ILSA (Italian Longitudinal Study on Aging). Methods: The study examined 5632 individuals aged 65–84 years, living either independently or in institutions. Of the above number, 2109 subjects were examined in the 1996 follow-up, with evaluation of the diabetic status and osteoarthritis symptoms (at least one of the following sites: hand, knee, shoulder, hip). Associations between diabetes and osteoarthritis symptoms were examined by means of the χ² test or the non-parametric Wilcoxon rank-sum test. Relationships of diagnoses of osteoarthritis and possible risk factors were analysed by multinomial logistic regression, adjusting for significant interactions. Results: Only for shoulders did osteoarthritis symptoms reveal a significant association with diabetes (p=0.0107). Significant risk factors for shoulder osteoarthritis were gender, age, completed years of schooling, BMI and diabetes. A woman of ≤76 years was 3.3 times more likely to have definite osteoarthritis and almost 2 times more likely to have possible osteoarthritis than a man of similar age. A man of over 76 years was estimated to be 3.5 times as likely to have definite osteoarthritis and almost 1.6 times more likely to have possible osteoarthritis than a younger man. Conclusions: It was concluded that the high prevalence rates of osteoarthritis symptoms in diabetic patients should be a major concern when planning treatment, because they might lead to a reduction in physical exercise, due to joint pain. Common pathophysiological pathways should be identified, such as RANKL/OPG and inflammation markers, to explain the independent association of these disabling conditions.