Clinical complexity and mortality in middle-aged and older adults with diabetes

J Gerontol A Biol Sci Med Sci. 2012 Dec;67(12):1313-20. doi: 10.1093/gerona/gls095. Epub 2012 Apr 6.

Abstract

Background: Middle-aged and older adults with diabetes are heterogeneous and may be characterized as belonging to one of three clinical groups: a relatively healthy group, a group having characteristics likely to make diabetes self-management difficult, and a group with poor health status for whom current management targets have uncertain benefit.

Methods: We analyzed waves 2004-2008 of the Health and Retirement Study and the supplemental Health and Retirement Study 2003 Diabetes Study. The sample included adults with diabetes 51 years and older (n = 3,507, representing 13.6 million in 2004). We investigated the mortality outcomes for the three clinical groups, using survival analysis and Cox proportional hazard models.

Results: The 5-year survival probabilities were Relatively Healthy Group, 90.8%; Self-Management Difficulty Group, 79.4%; and Uncertain Benefit Group, 52.5%. For all age groups and clinical groups, except those 76 years and older in the Uncertain Benefit Group, survival exceeded 50%.

Conclusions: This study reveals the substantial survival of middle-aged and older adults with diabetes, regardless of health status. These findings have implications for the clinical management of and future research about diabetes patients with multiple comorbidities.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Comorbidity
  • Diabetes Complications / epidemiology
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / mortality*
  • Diabetes Mellitus / therapy*
  • Female
  • Health Status*
  • Humans
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Self Care