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Published on: June 11, 2012

Diabetes, comorbidities and increased long-term mortality in older patients admitted for geriatric inpatient care

D Zekry1, E Frangos, C Graf

  • 1Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, 3 chemin du Pont-Bochet, Thônex, Switzerland.

Diabetes & Metabolism
|November 26, 2011
PubMed

Insights

Diabetes increases mortality risk in the very old, particularly when combined with other health issues. Managing overall comorbidity load and functional decline is key for better outcomes in elderly diabetic patients.

Area of Science:

  • Geriatric Medicine
  • Endocrinology
  • Public Health

Background:

  • Diabetes is a prevalent condition in the elderly.
  • Older adults often present with multiple comorbidities and functional limitations.
  • The impact of diabetes on mortality in this specific population requires further investigation.

Purpose of the Study:

  • To investigate the specific impact of diabetes on long-term mortality in very old individuals with multiple comorbidities.
  • To assess the role of comorbidities and functional disabilities in the relationship between diabetes and mortality.
  • To provide insights for improving the prognosis of elderly diabetic patients.

Main Methods:

  • A cohort of 444 elderly patients (mean age 85.3 years) admitted to a geriatric service was studied.
  • Data collected included diabetes status, vascular disorders, comorbidity load (CIRS), and functional status (ADL, IADL).
  • Cox proportional-hazards models were used to analyze the 4-year mortality risk associated with diabetes.

Main Results:

  • Diabetic patients exhibited higher BMI, hypertension, ischemic heart disease, comorbidities (CIRS), and functional disabilities.
  • Diabetes was associated with increased 4-year mortality (HR: 1.42), even after adjusting for age, gender, and BMI.
  • This association was attenuated by individual vascular comorbidities and disappeared when adjusting for global comorbidity load (CIRS) or functional disabilities (ADL/IADL).

Conclusions:

  • Diabetes is linked to increased mortality in the very old, an association mediated by overall comorbidity burden and functional status.
  • Individual vascular conditions did not fully explain the increased mortality risk in diabetic elderly patients.
  • Comprehensive management of all comorbidities and functional impairments is crucial for improving survival in older adults with diabetes.
Abstract

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