Epidemiology of Diabetes and Diabetes Complications in the Elderly: An Emerging Public Health Burden

Diabetes in the elderly is a growing public health burden. Persons with diabetes are living longer and are vulnerable to the traditional microvascular and macrovascular complications of diabetes but also at increased risk for geriatric syndromes. Peripheral vascular disease, heart disease, and stroke all have a high prevalence among older adults with diabetes. Traditional microvascular complications such as retinopathy, nephropathy, and neuropathy also frequently occur. Unique to this older population is the effect of diabetes on functional status. Older adults with diabetes are also more likely to experience geriatric syndromes such as falls, dementia, depression, and incontinence. Further studies are needed to better characterize those elderly individuals who may be at the highest risk of adverse complications from diabetes.

[1]  K. Suastika,et al.  Age and homocystein were risk factor for peripheral arterial disease in elderly with type 2 diabetes mellitus. , 2010, Acta medica Indonesiana.

[2]  G. Eknoyan,et al.  Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. , 2003, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[3]  M. Malaguarnera,et al.  Cardio-cerebrovascular complications in elderly with diabetes. , 2007, Archives of gerontology and geriatrics.

[4]  J. J. Wang,et al.  Relationship of Type 2 diabetes to the prevalence, incidence and progression of age‐related hearing loss , 2009, Diabetic Medicine.

[5]  K. Ko,et al.  Prevalence and clinical characteristics of diabetic peripheral neuropathy in hospital patients with Type 2 diabetes in Korea , 2012, Diabetic medicine : a journal of the British Diabetic Association.

[6]  H. Hoffman,et al.  Risk Factors for Hearing Impairment Among U.S. Adults With Diabetes , 2011, Diabetes Care.

[7]  Hideki Ito,et al.  Low Well‐Being Is an Independent Predictor for Stroke in Elderly Patients with Diabetes Mellitus , 2004, Journal of the American Geriatrics Society.

[8]  Sex differences in the impact of diabetes on the risk of geriatric conditions , 2013, Geriatrics & gerontology international.

[9]  P. Hogan,et al.  Economic Costs of Diabetes in the U , 2013 .

[10]  L. Fried,et al.  Frailty in older adults: evidence for a phenotype. , 2001, The journals of gerontology. Series A, Biological sciences and medical sciences.

[11]  Pamela J Schreiner,et al.  Older women with diabetes have a higher risk of falls: a prospective study. , 2002, Diabetes care.

[12]  Thomas J. Songer,et al.  Improvements in the Life Expectancy of Type 1 Diabetes , 2012, Diabetes.

[13]  R. Varadhan,et al.  Frailty status and altered glucose-insulin dynamics. , 2012, The journals of gerontology. Series A, Biological sciences and medical sciences.

[14]  K. Coyne,et al.  The impact of overactive bladder, incontinence and other lower urinary tract symptoms on quality of life, work productivity, sexuality and emotional well‐being in men and women: results from the EPIC study , 2008, BJU international.

[15]  L. Egede Diabetes, major depression, and functional disability among U.S. adults. , 2004, Diabetes care.

[16]  Hylton B Menz,et al.  Walking stability and sensorimotor function in older people with diabetic peripheral neuropathy. , 2004, Archives of physical medicine and rehabilitation.

[17]  Thomas R. Frieden,et al.  Self-reported visual impairment among persons with diagnosed diabetes --- United States, 1997--2010. , 2011, MMWR. Morbidity and mortality weekly report.

[18]  J. Ross,et al.  Association of Chronic Diseases and Impairments With Disability in Older Adults: A Decade of Change? , 2012, Medical care.

[19]  J. Neuhaus,et al.  Type 2 Diabetes and 10-Year Risk of Dementia and Cognitive Impairment Among Older Mexican Americans , 2013, Diabetes Care.

[20]  L. Pogach,et al.  Risk of Hypoglycemia in Older Veterans with Dementia and Cognitive Impairment: Implications for Practice and Policy , 2011, Journal of the American Geriatrics Society.

[21]  L. Kuller,et al.  Lipoprotein(a) Concentration Shows Little Relationship to IDDM Complications in the Pittsburgh Epidemiology of Diabetes Complications Study Cohort , 1993, Diabetes Care.

[22]  James P. Boyle,et al.  Impact of Recent Increase in Incidence on Future Diabetes Burden , 2006, Diabetes Care.

[23]  F. Andrade Measuring the impact of diabetes on life expectancy and disability-free life expectancy among older adults in Mexico. , 2010, The journals of gerontology. Series B, Psychological sciences and social sciences.

[24]  G. Habib,et al.  Silent myocardial ischemia in patients with diabetes: who to screen. , 1999, Diabetes care.

[25]  A. Gousse,et al.  Bladder Dysfunction in Patients with Diabetes , 2011, Current urology reports.

[26]  L. Fried,et al.  Frailty, hospitalization, and progression of disability in a cohort of disabled older women. , 2005, The American journal of medicine.

[27]  S. K. Van Den Eeden,et al.  Women with diabetes: understanding urinary incontinence and help seeking behavior. , 2010, The Journal of urology.

[28]  K. Hall,et al.  Diabetes and cognitive decline in elderly African Americans: A 15-year follow-up study , 2011, Alzheimer's & Dementia.

[29]  R. J. Johnson,et al.  Changes in functional status and the risks of subsequent nursing home placement and death. , 1993, Journal of gerontology.

[30]  John K Niparko,et al.  Risk Factors for Hearing Loss in US Adults: Data From the National Health and Nutrition Examination Survey, 1999 to 2002 , 2009, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[31]  Ann L. Albright,et al.  Prevalence of diabetic retinopathy in the United States, 2005-2008. , 2010, JAMA.

[32]  Mark E. Williams,et al.  Geriatric nephrology: responding to a growing challenge. , 2010, Clinical journal of the American Society of Nephrology : CJASN.

[33]  A. Arastoo,et al.  Functional balance in elderly with diabetic neuropathy. , 2012, Diabetes research and clinical practice.

[34]  C. Ionescu-Tirgoviste,et al.  Improvements in life expectancy in adult type 2 diabetes patients in the last six decades. , 2009, Diabetes research and clinical practice.

[35]  D. Palacios-Ceña,et al.  Trends in the prevalence of physical and functional disability among Spanish elderly suffering from diabetes (2000-2007). , 2011, Diabetes research and clinical practice.

[36]  N. Çınar,et al.  The association between diabetes mellitus and urinary incontinence in adult women , 2009, International Urogynecology Journal.

[37]  Desmond E. Williams,et al.  Full Accounting of Diabetes and Pre-Diabetes in the U.S. Population in 1988–1994 and 2005–2006 , 2009, Diabetes Care.

[38]  C. Ionescu-Tirgoviste,et al.  Improvements in life expectancy in type 1 diabetes patients in the last six decades. , 2009, Diabetes research and clinical practice.

[39]  P. Lips,et al.  Older individuals with diabetes have an increased risk of recurrent falls: analysis of potential mediating factors: the Longitudinal Ageing Study Amsterdam. , 2012, Age and ageing.

[40]  R. Kronmal,et al.  Methods and Findings , 2022 .

[41]  Keith C. Norris,et al.  Prevalence of CKD and comorbid illness in elderly patients in the United States: results from the Kidney Early Evaluation Program (KEEP). , 2010, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[42]  Elizabeth Selvin,et al.  Association of Diabetes, Comorbidities, and A1C With Functional Disability in Older Adults , 2010, Diabetes Care.

[43]  L. Fried,et al.  Insulin resistance and inflammation as precursors of frailty: the Cardiovascular Health Study. , 2007, Archives of internal medicine.

[44]  C. Escobar,et al.  Prevalence and clinical profile and management of peripheral arterial disease in elderly patients with diabetes. , 2011, European journal of internal medicine.

[45]  J. Killian,et al.  Coronary atherosclerosis in diabetes mellitus: a population-based autopsy study. , 2002, Journal of the American College of Cardiology.

[46]  E. Margaret Warton,et al.  The Association Between the Number of Prescription Medications and Incident Falls in a Multi-ethnic Population of Adult Type-2 Diabetes Patients: The Diabetes and Aging Study , 2010, Journal of General Internal Medicine.

[47]  C. Yen,et al.  Effects of Age and Diabetes on Blood Flow Rate and Primary Outcome of Newly Created Hemodialysis Arteriovenous Fistulas , 1998, American Journal of Nephrology.

[48]  W. Aronow,et al.  Diabetes mellitus in older African-Americans, Hispanics, and whites in an academic hospital-based geriatrics practice. , 1999, Coronary artery disease.

[49]  Plamen Nikolov,et al.  Economic Costs of Diabetes in the U.S. in 2002 , 2003, Diabetes care.

[50]  L. Egede,et al.  Comorbid depression is associated with increased health care use and expenditures in individuals with diabetes. , 2002, Diabetes care.

[51]  Hsing-Yi Chang,et al.  The excess mortality risk of diabetes associated with functional decline in older adults: Results from a 7-year follow-up of a nationwide cohort in Taiwan , 2011, BMC public health.

[52]  J. Alonso Prevalencia de diabetes mellitus en pacientes geriátricos institucionalizados en la provincia de Cádiz. Estudio Diagerca , 2012 .

[53]  The Association of Diabetes, Comorbidities, and Hemoglobin A1c with Functional Disability in Older Adults: Results from the National Health and Nutrition Examination Survey (NHANES), 1999-2006 Running Title: Diabetes And Functional Disability In Older Adults , 2010 .

[54]  L. Fried,et al.  Is Hyperglycemia Associated with Frailty Status in Older Women? , 2009, Journal of the American Geriatrics Society.

[55]  R. Dankner,et al.  Undetected type 2 diabetes in older adults. , 2008, Age and ageing.

[56]  L. Ferrucci,et al.  Phenotype of frailty: characterization in the women's health and aging studies. , 2006, The journals of gerontology. Series A, Biological sciences and medical sciences.

[57]  L. Fried,et al.  Frailty and activation of the inflammation and coagulation systems with and without clinical comorbidities: results from the Cardiovascular Health Study. , 2002, Archives of internal medicine.

[58]  S. Kritchevsky,et al.  Diabetes mellitus, glycemic control, and incident depressive symptoms among 70- to 79-year-old persons: the health, aging, and body composition study. , 2007, Archives of internal medicine.

[59]  I. Deary,et al.  Severe hypoglycaemia and late‐life cognitive ability in older people with Type 2 diabetes: the Edinburgh Type 2 Diabetes Study , 2012, Diabetic medicine : a journal of the British Diabetic Association.

[60]  W. Cheung,et al.  Older people with diabetes have higher risk of depression, cognitive and functional impairments: Implications for diabetes services , 2011, The journal of nutrition, health & aging.

[61]  L. Fried,et al.  Hyperglycemia and Incidence of Frailty and Lower Extremity Mobility Limitations in Older Women , 2012, Journal of the American Geriatrics Society.