Differences in diabetes prevalence, incidence, and mortality among the elderly of four racial/ethnic groups: Whites, blacks, Hispanics, and Asians
ABSTRACT To examine diabetes prevalence, incidence, and mortality from 1993 to 2001 among fee-for-service Medicare beneficiaries > or = 67 years of age.
This study was a retrospective analysis of a 5% random sample of Medicare fee-for-service beneficiaries > or = 65 years of age in each year.
In 1993, the prevalence of diabetes among those > or = 67 years of age was 145 cases per 1,000 individuals. By 2001, it was 197/1,000, an increase of 36.0%. The 2001 prevalence among Hispanics (334/1,000) was significantly higher than among blacks (296/1,000), Asians (243/1,000), and whites (184/1,000, P < 0.0001). During the 7-year period the greatest increase in diabetes prevalence was among Asians (68.0%). Between 1994 and 2001, the annual rate of newly diagnosed elderly individuals with diabetes increased by 36.9%. Hispanics had the greatest increase at 55.0%. The mortality rate among individuals with diabetes decreased by approximately 5% between 1994 and 2001 from 92.1/1,000 to 87.2/1,000 (P < 0.001), due to a 6% decrease among whites. No decrease in mortality was seen among elderly individuals without diabetes, it was 55/1,000 in 1994 and 54/1,000 in 2001.
The dramatic increase in the incidence and prevalence of diabetes likely reflect a combination of true increases, as well as changes in the diagnostic criteria and increased interest in diagnosing and appropriately treating diabetes in the elderly. Improved treatment may have had an impact on mortality rates among individuals with diabetes, although they could have been influenced by the duration of diabetes before diagnosis, which has likely decreased. Changes in incidence, prevalence, and mortality in elderly individuals with diabetes need to continue to be monitored.
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ABSTRACT: Aim: To evaluate the effect of diabetes onset on health-related quality of life (HRQoL) in men. Methods: A prospective cohort study with a 34-year follow-up (The Helsinki Businessmen Study, Finland). A socio-economically homogenous group of 1815 men (born 1919-1934), free of diabetes and clinically healthy in 1974, when cardiovascular risk factors were measured and self-related health (SRH) evaluated with a five-step scale. In 2000 and 2007, HRQoL was assessed with a questionnaire, including the RAND-36 (SF-36) instrument. Incidence of diabetes up to 2007 was retrieved using the National Reimbursement Register for diabetes medication, or from questionnaire surveys between 2000 and 2007. Onset of diabetes was divided as follows: 1991 or earlier, 1992-1995, 1996-2000, 2001-2003, 2004-2007. Results: Altogether 216 men (11.9%) developed diabetes during the 34-year follow-up, and they had more cardiovascular risk factors at baseline than those without diabetes. According to the evaluation in 2000, and compared to men free of diabetes during follow-up, three RAND-36 scales (physical function, general health, social functioning) were significantly worsened already after 0-4 years from diabetes onset and did not deteriorate thereafter. Instead, HRQoL was not worsened up to 7 years before diabetes onset (between 2000 and 2007). No consistent impact of diabetes was observed on mental health-related scales. Conclusion: Diabetes does not affect physical health-related quality of life until after diabetes onset. Lack of an association between the prediabetic state and HRQoL may offer an important window for the prevention and argument for early detection also from the HRQoL viewpoint.European geriatric medicine 09/2013; 4(4):217-220. DOI:10.1016/j.eurger.2013.04.009 · 0.55 Impact Factor