{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T04:01:49Z","timestamp":1792555309273,"version":"4.5.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T00:00:00Z","timestamp":1664150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014125","name":"Fujian Provincial Health Commission","doi-asserted-by":"publisher","award":["2018-CXB-16"],"award-info":[{"award-number":["2018-CXB-16"]}],"id":[{"id":"10.13039\/501100014125","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Type 2 diabetes mellitus (T2DM) is an independent risk factor for functional limitations among the older population. The predicted increase in T2DM cases combined with the ongoing rapidly aging population may further burden the already overloaded healthcare system and aggravate the loss of economic self-sufficiency. This study aimed to investigate the activities of daily living (ADL) and its influencing factors on older people with T2DM, and to provide implications for the development and improvement of community nursing services in the context rapidly aging population in China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From March 2019 to June 2020, we conducted a cross-sectional questionnaire survey among older T2DM patients in Fuzhou, using a multi-stage cluster sampling approach. Functional status was measured by the Lawton ADL scale. Stata \u201cnptrend\u201d test was used to examine the trend of ordinal variables on ADL. Non-conditional logistic regression was used to identify factors affecting ADL limitations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2016 questionnaires were received, with a response rate of 96%. 12.4% of participants suffered from varying degrees of functional impairment. ADL limitations increased with age. More comorbidities were associated with a greater risk of developing functional limitations in ADLs. the following sub-groups were more likely to suffer from ADL impairment: those aged 70 and over years (OR = 1.99, 95%CI 1.77\u20132.56), living in an aged care house or with spouse\/children (OR = 2.31, 95%CI 1.25\u20134.26), low monthly income (OR = 1.49, 95%CI 1.28\u20131.64), without health insurance (OR = 1.82, 95%CI 1.40\u20132.40), tight family expenses (OR = 1.95, 95%CI 1.42\u20132.69), having stroke (OR = 6.70, 95%CI 2.22\u201320.23) or malignant tumor (OR = 4.45, 95%CI 1.27\u201315.53), irregular eating habit (OR = 2.55, 95%CI 2.23\u20132.92), smoking (OR = 1.40, 95%CI 1.22\u20131.60), sedentary lifestyle (OR = 2.04, 95%CI 1.46\u20132.85), lack of physical exercise (OR = 1.35, 95%CI 1.19\u20131.53), sleeping difficulty (OR = 1.25, 95%CI 1.10\u20131.42), and lack of family support (OR = 1.19, 95%CI 1.10\u20131.29).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Older adults (\u226570 years) with T2DM had a high prevalence of functional limitations across a range of daily living tasks, which not only affect individual life of quality but also present a huge burden on the family, health services system, and the whole society. Identified factors associated with ADL limitations may provide useful information for targeted nursing practice and health promotion.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2022.948533","type":"journal-article","created":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T05:38:19Z","timestamp":1664170699000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Activities of daily living and its influencing factors for older people with type 2 diabetes mellitus in urban communities of Fuzhou, China"],"prefix":"10.3389","volume":"10","author":[{"given":"Jin-Hua","family":"Jie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Na","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifeng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bailing","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuancheng","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baoying","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongxian","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianjun","family":"Xiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai-Lin","family":"Zhuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,26]]},"reference":[{"key":"B1","unstructured":"IDF Diabetes Atlas 2021. 10"},{"key":"B2","doi-asserted-by":"publisher","first-page":"3","DOI":"10.2337\/dbi17-0013","article-title":"Diabetes in China: epidemiology and genetic risk factors and their clinical utility in personalized medication","volume":"67","author":"Hu","year":"2018","journal-title":"Diabetes."},{"key":"B3","doi-asserted-by":"publisher","first-page":"107","DOI":"10.2991\/jegh.k.191028.001","article-title":"Epidemiology of type 2 diabetes\u2013global burden of disease and forecasted trends","volume":"10","author":"Khan","year":"2020","journal-title":"J Epidemiol Glob Health."},{"key":"B4","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1016\/j.diabet.2018.08.008","article-title":"Burden of diabetes, hyperglycaemia in China from to 2016: Findings from the 1990 to 2016, global burden of disease study","volume":"45","author":"Liu","year":"2019","journal-title":"Diabetes Metab."},{"key":"B5","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1016\/j.jamda.2013.02.006","article-title":"Patients with type 2 diabetes show a greater decline in muscle mass, muscle strength, and functional capacity with aging","volume":"14","author":"Leenders","year":"2013","journal-title":"J Am Med Dir Assoc."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1226","DOI":"10.12998\/wjcc.v10.i4.1226","article-title":"What are the self-management experiences of the elderly with diabetes? A systematic review of qualitative research","volume":"10","author":"Li","year":"2022","journal-title":"World J Clin Cases."},{"key":"B7","first-page":"1","article-title":"Summary health statistics for U.S. adults: national health interview survey, 2012","author":"Blackwell","year":"2014","journal-title":"Vital Health Stat 10"},{"key":"B8","doi-asserted-by":"publisher","first-page":"314","DOI":"10.2337\/diacare.26.2.314","article-title":"Diabetes as a predictor of change in functional status among older Mexican Americans: a population-based cohort study","volume":"26","author":"Wu","year":"2003","journal-title":"Diabetes Care."},{"key":"B9","doi-asserted-by":"publisher","first-page":"M90","DOI":"10.1093\/gerona\/55.2.M90","article-title":"Self-reported prevalence and health correlates of functional limitation among Massachusetts elderly Puerto Ricans, Dominicans, and non-Hispanic white neighborhood comparison group","volume":"55","author":"Tucker","year":"2000","journal-title":"J Gerontol A Biol Sci Med Sci."},{"key":"B10","doi-asserted-by":"publisher","first-page":"e15849","DOI":"10.1097\/MD.0000000000015849","article-title":"Socioeconomic status moderates the association between patient satisfaction with community health service and self-management behaviors in patients with type 2 diabetes: a cross-sectional survey in China","volume":"98","author":"Yin","year":"2019","journal-title":"Medicine."},{"key":"B11","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1186\/s12913-017-2200-9","article-title":"Residents' satisfaction with primary medical and health services in Western China","volume":"17","author":"Dong","year":"2017","journal-title":"BMC Health Serv Res."},{"key":"B12","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.glohj.2020.01.002","article-title":"Aging in China: perspectives on public health","volume":"4","author":"Han","year":"2020","journal-title":"Glob Health J."},{"key":"B13","unstructured":"Population of Fuzhou in 2020 2021"},{"key":"B14","doi-asserted-by":"publisher","first-page":"777654","DOI":"10.3389\/fendo.2021.777654","article-title":"Trends in diabetes mortality in urban and rural China, 1987-2019: a joinpoint regression analysis","volume":"12","author":"Su","year":"2021","journal-title":"Front Endocrinol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"251","DOI":"10.16440\/j.cnki.1674-8166.2018.03.005","article-title":"Death status of patients with diabetes mellitus in Fuzhou City from 2011 to 2016 (in Chinese)","volume":"19","author":"Zheng","year":"2018","journal-title":"Chronic Pathematology J."},{"key":"B16","doi-asserted-by":"publisher","first-page":"40","DOI":"10.16658\/j.cnki.1672-4062.2020.21.040","article-title":"Investigation on the prevalence of diabetes and its influencing factors in Fuzhou residents (in Chinese)","volume":"23","author":"Xu","year":"2020","journal-title":"Diabetes New World."},{"key":"B17","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1186\/s12992-019-0486-6","article-title":"The development and reform of public health in China from 1949 to 2019","volume":"15","author":"Wang","year":"2019","journal-title":"Global Health."},{"key":"B18","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1093\/geront\/9.3_Part_1.179","article-title":"Assessment of older people: self-maintaining and instrumental activities of daily living","volume":"9","author":"Lawton","year":"1969","journal-title":"Gerontologist."},{"key":"B19","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1002\/sim.4780040112","article-title":"A Wilcoxon-type test for trend","volume":"4","author":"Cuzick","year":"1985","journal-title":"Stat Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"14790","DOI":"10.1038\/s41598-020-71908-9","article-title":"Global, regional, and national burden and trend of diabetes in 195 countries and territories: an analysis from 1990 to 2025","volume":"10","author":"Lin","year":"2020","journal-title":"Sci Rep."},{"key":"B21","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/j.cger.2020.04.002","article-title":"Cognitive dysfunction in older adults with type 2 diabetes: links, risks, and clinical implications","volume":"36","author":"Sinclair","year":"2020","journal-title":"Clin Geriatr Med."},{"key":"B22","doi-asserted-by":"publisher","first-page":"43","DOI":"10.3928\/00989134-20190211-05","article-title":"Type 2 diabetes self-management barriers in older adults: an integrative review of the qualitative literature","volume":"45","author":"Saunders","year":"2019","journal-title":"J Gerontol Nurs."},{"key":"B23","doi-asserted-by":"publisher","first-page":"38937","DOI":"10.1038\/srep38937","article-title":"Type 2 diabetes mellitus is associated with increased risks of sarcopenia and pre-sarcopenia in Chinese elderly","volume":"6","author":"Wang","year":"2016","journal-title":"Sci Rep."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1272","DOI":"10.2337\/diacare.23.9.1272","article-title":"Diabetes and physical disability among older US adults","volume":"23","author":"Gregg","year":"2000","journal-title":"Diabetes Care."},{"key":"B25","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1097\/01.NAJ.0000314810.46029.74","article-title":"The Lawton instrumental activities of daily living scale","volume":"108","author":"Graf","year":"2008","journal-title":"Am J Nurs."},{"key":"B26","doi-asserted-by":"publisher","first-page":"2113","DOI":"10.1093\/gerona\/glz221","article-title":"Trends in the incidence of activities of daily living disability among Chinese older adults from 2002 to 2014","volume":"75","author":"Li","year":"2020","journal-title":"J Gerontol A Biol Sci Med Sci."},{"key":"B27","doi-asserted-by":"publisher","first-page":"e0165127","DOI":"10.1371\/journal.pone.0165127","article-title":"Limitations in activities of daily living in community-dwelling people aged 75 and over: a systematic literature review of risk and protective factors","volume":"11","author":"Van","year":"2016","journal-title":"PLoS ONE."},{"key":"B28","doi-asserted-by":"publisher","first-page":"33","DOI":"10.3760\/cma.j.issn.0254-6450.2019.01.008","article-title":"A cohort study on the influence of the chronic diseases on activities of daily living of the elderly aged 65 years and over in China","volume":"40","author":"Li","year":"2019","journal-title":"Chin J Epidemiol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/2251-6581-13-3","article-title":"Cross-country differences in the association between diabetes and disability","volume":"13","author":"Assari","year":"2014","journal-title":"J Diabetes Metab Disord."},{"key":"B30","doi-asserted-by":"publisher","first-page":"4364","DOI":"10.3969\/j.issn.1007-9572.2016.35.015","article-title":"Investigation of effects of chronic eiseases on activities of eaily living abilities of the elderly in China","volume":"19","author":"Qian","year":"2016","journal-title":"J Chin Gen Pract."},{"key":"B31","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1093\/ije\/dys203","article-title":"Cohort profile: the China health and retirement longitudinal study (CHARLS)","volume":"43","author":"Zhao","year":"2014","journal-title":"Int J Epidemiol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.2337\/dc09-1597","article-title":"Association of diabetes, comorbidities, and A1C with functional disability in older adults: results from the National Health and Nutrition Examination Survey (NHANES), 1999\u20132006","volume":"33","author":"Kalyani","year":"2010","journal-title":"Diabetes Care."},{"key":"B33","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1300\/J074v14n01_04","article-title":"Life with and without disease: women experience more of both","volume":"14","author":"Crimmins","year":"2002","journal-title":"J Women Aging."},{"key":"B34","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1016\/0277-9536(91)90293-L","article-title":"Gender differences in health related behaviour: some unanswered questions","volume":"32","author":"Kandrack","year":"1991","journal-title":"Soc Sci Med."},{"key":"B35","unstructured":"National bulletin on the development of aging health affairs in 2020"},{"key":"B36","doi-asserted-by":"publisher","first-page":"837431","DOI":"10.3389\/fpubh.2021.837431","article-title":"Social pension scheme and health inequality: evidence from China's new rural social pension scheme","volume":"9","author":"Yuan","year":"2021","journal-title":"Front Public Health."},{"key":"B37","unstructured":"Which types of verified special diseases are eligible for compensation and which diseases are counted as special diseases?"},{"key":"B38","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1001\/archfami.9.10.1111","article-title":"Selection bias from requiring patients to give consent to examine data for health services research","volume":"9","author":"Woolf","year":"2000","journal-title":"Arch Fam Med."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.948533\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T10:25:58Z","timestamp":1664360758000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.948533\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,26]]},"references-count":38,"alternative-id":["10.3389\/fpubh.2022.948533"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2022.948533","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,26]]},"article-number":"948533"}}