Diabetes in older people: Prevalence, incidence and its association with medium- and long-term mortality from all causes

作者：Sanchez Martinez Mercedes; Blanco Augusto; Victoria Castell Maria; Gutierrez Misis Alicia; Gonzalez Montalvo Juan Ignacio; Victoria Zunzunegui Maria; Otero Angel

来源：Atencion Primaria, 2014, 46(7): 376-384.

DOI：10.1016/j.aprim.2013.12.004

• Diabetes
• Elderly
• Prevalence
• Incidence
• Mortality
• Cohort studies

Objective: To estimate the prevalence and incidence of self-reported diabetes and to study its association with medium- and long-term mortality from all causes in persons >= 65 years.
Design: A population-based cohort study begun in 1993.
Setting: "Envejecer en Leganes" cohort (Madrid).
Participants: A random sample of persons >= 65 years (n=1277 in the 1993 baseline sample).
Methods: Participants were classified as having diabetes if they so reported and had consulted a physician for this reason within the last year. Diabetes history was categorized in <10 and >= 10 years in 1993. Incidence density was calculated in 2-year periods in non-diabetic individuals (1965 persons/2 years). Vital status was recorded on 31 December 2011. The association between diabetes history >= 10 years and mortality at 6 and 18 years follow-up was studied by the Kaplan-Meier and Cox regression analyses after adjusting for age, sex, heart disease and comorbidity.
Results: The prevalence of self-reported diabetes rose from 10.3% in 1993 to 16.1% in 1999 (p <= 0.001) and was higher in women than men (p <= 0.05). Total incidence density was 2.6 cases/100 persons/2 years (95% CI: 2.0-3.3). Medium- and long-term mortality was higher in persons with diabetes history >= 10 years than in non-diabetic individuals (HR: 2.0; 95% CI: 1.2-3.3 and HR: 1.7; 95% CI: 1.1-2.5, respectively). In diabetics with history <10 years the HR was 1.3 (95% CI: 0.9-1.9) and HR: 1.5 (95% CI: 1.2-1.9, respectively).
Conclusions: Although diabetes is clearly associated with increased risk of mortality, it is significant only for patients with >= 10 years' history of diabetes.

• 出版日期2014-9