Behavioral and Psychological Factors in Buffering Diabetes-related Disability Development

Background Diabetes is associated with disability development. Healthy behaviors and psychosocial support can help patients manage their disease. Purpose To examine the role of various behavioral and psychological factors in buffering the effect of diabetes on disability development over time in Taiwanese adults. Methods Data on 5,131 adults aged ≥50 years were obtained from the Taiwan Longitudinal Study on Aging. A cohort sequential multilevel design was employed to analyze the association between behavioral and psychosocial factors and the risk of disability over a 11-year period. Results In patients with diabetes, having social support and exercising more than six times a week were associated with 4% and 49% reductions in the risk of disability, respectively (β_diabetes*_{socialsupport} = −0.285, p = .006; β_diabetes*_exercise3 = −2.612, p = .007). Exercising more than six times a week had an additional significant protective effect against disability development per year (β_diabetes*exercises3_*age = −0.241, p = .038). Depression did not significantly interact with diabetes. However, a trajectory analysis revealed that individuals who had both diabetes and depression had the highest disability score from middle age among all participants. Conclusions Engaging in frequent exercise is the most influential factor for reducing the risk of disability in patients with diabetes. Social support provides an additional benefit for disability prevention in individuals with diabetes.