Quality of life in older adults with diabetic peripheral neuropathy: International Classification of Functioning, Disability and Health (ICF) framework

Abstract

Introduction: The decrease in quality of life (QoL) in individuals with diabetic peripheral neuropathy (DPN) is still debated, with differing opinions on its root causes. Objective: To investigate the factors contributing to this decline by applying the International Classification of Functioning, Disability and Health (ICF) framework. Methods: A cross-sectional study was conducted involving 242 older adults with type 2 diabetes mellitus from the community of Sukoharjo. This study was divided into two groups: those with DPN and those without DPN, which were identified through the physical test of the Michigan Neuropathy Screening Instrument. Another variable was observed, including QoL, age, body mass index, gender, blood pressure, hypertension status, hemoglobin, visual function, fear of falling, duration, neuropathy pain, falls history, lower extremity muscle strength, cognition, depression, cardiovascular endurance, and balance. The statistical analysis used the comparison test and multiple linear regression. Results: Multiple linear regression analysis showed cognitive function was most significantly associated with QoL in DPN group (B = 0.296, SE = 0.136, p = 0.032), followed by visual function (B = -0.150, SE = 0.051, p = 0.004) and static balance (B = 0.140, SE = 0.061, p = 0.024). While in the non-DPN group, the falls history was interpreted as the strongest factor influencing QoL (B = -4.691, SE = 1.454, p = 0.002) and also associated with duration of diabetes mellitus (B = -0.915, SE = 0.302, p = 0.003). Conclusion: Based on the ICF framework, sensory deficits, especially in vision, may worsen functional limits and lower QoL in DPN. Targeted treatment of visual and balance issues could help improve outcomes.