Mortality and Cardiovascular Complications in Older Complex Chronic Patients with Type 2 Diabetes

Determining the prevalence of diabetes and its cardiovascular complications and all-cause mortality in older chronic complex patients.

We carried out a multicenter retrospective study and included a randomized sample of 932 CCP people. We assessed the prevalence of diabetes according to World Health Organization criteria. Data included demographics and functional, comorbidity, cognitive, and social assessment.

The prevalence of diabetes was 53% and average age 81.16 ± 8.93 years. There were no significant differences in the survival of CCP patients with or without DM, with or without ischaemic cardiopathy, and with or without peripheral vascular disease. The prognostic factors of all-cause mortality in patients with DM were age ≥ 80 years [HR 1.47, 95% CI 1.02-2.13, p  0.038], presence of heart failure [HR 1.73, 95% CI 1.25-2.38, p  0.001], Charlson score [HR 1.20, 95% CI 1.06-1.36, p  0.003], presence of cognitive impairment [HR 1.73, 95% CI 1.24-2.40, p  0.001], and no treatment with statins [HR 1.49, 95% CI 1.08-2.04, p  0.038].

We found high prevalence of DM among CCP patients and the relative importance of traditional risk factors seemed to wane with advancing age. Recommendations may include relaxing treatment goals, providing family/patient education, and enhanced communication strategies.