PS-P11-2: THE PATTERN OF PHYSICAL DISABILITY AND DETERMINANTS OF ACTIVITIES OF DAILY LIVING AMONG DIABETIC PATIENTS IN BANGLADESH: A CROSS-SECTIONAL ANALYSIS.

Abstract

Objective: Diabetes mellitus is a known predictor of physical disability and decline in activities of daily living (ADL); however, there are existing controversies about the factors explaining the association between diabetes and disability. Therefore, we assessed the proportion of physical disabilities and possible factors associated with ADL decline among diabetic patients in Bangladesh. Design and Methods: We conducted a cross-sectional study among 480 diabetic individuals from a tertiary level hospital in Dhaka, Bangladesh, aged between 40 and 85 years. For determining the ADL decline, we used the Katz Index Scoring, the highest score of 6 indicates no ADL decline. We divided patients into two groups depending on ADL impairment to compare the population characteristics using the unpaired Students t-test or Wilcoxon rank-sum test for continuous variables and the chi-squared test for categorical variables. Age, sex, educational attainment, household expenditure, BMI, HbA1c, hypertension, and medication adherence to anti-diabetic drugs were included in the statistical models. We defined any ADL decline as an event, and multivariable logistic regression was performed to assess the factors associated with ADL decline. Results: The mean age of the participants was 59.0 (standard deviation [SD], 7.0) years. The majority of the participants (76.3%) had at least some sort of physical disability. Age, educational attainment, household expenditure, systolic blood pressure, waist circumference, quality of life, and comorbidities were different among the groups stratified by ADL impairment status. In multivariable logistic regression analysis after adjusting for all covariates simultaneously, age (OR, 95% CI: 1.35, 1.20–1.75), lower educational attainment (0.97, 0.94–0.99), BMI (1.40, 1.12–1.75), existing comorbidities (2.79, 1.48–5.25) and uncontrolled diabetes (1.35,1.10–1.45) were independently associated with ADL decline among diabetic population. Conclusions: Physical disability was common, and ADL decline was associated with age, educational attainment, BMI, comorbidities, and uncontrolled diabetes among diabetic patients in Bangladesh.