Diabetes mellitus in elderly

Abstract

Diabetes mellitus (DM) frequency is a growing problem worldwide, because of long life expectancy and life style modifications. In old age (≥60–65 years old), DM is becoming an alarming public health problem in developed and even in developing countries as for some authors one from two old persons are diabetic or prediabetic and for others 8 from 10 old persons have some dysglycemia. DM complications and co-morbidities are more frequent in old diabetics compared to their young counterparts. The most frequent are cardiovascular diseases due to old age and to precocious atherosclerosis specific to DM and the most bothersome are visual and cognitive impairments, especially Alzheimer disease and other kind of dementia. Alzheimer disease seems to share the same risk factors as DM, which means insulin resistance due to lack of physical activity and eating disorders. Visual and physical handicaps, depression, and memory troubles are a barrier to care for DM treatment. For this, old diabetics are now classified into two main categories as fit and independent old people able to take any available medication, exactly as their young or middle age counterparts, and fragile or frail persons for whom physical activity, healthy diet, and medical treatment should be individualized according to the presence or lack of cognitive impairment and other co-morbidities. In the last category, the fundamental rule is “go slowly and individualize” to avoid interaction with poly medicated elder persons and fatal iatrogenic hypoglycemias in those treated with sulfonylureas or insulin.

Association between age associated cognitive decline and health related quality of life among Iranian older individuals

“…Socio-demographic variables (e.g. age, gender, marital status, educational level, job, family monthly income) were assessed based on the participants’ self-report (26), information regarding health conditions [history of heart disease, blood pressure (systolic/diastolic blood pressure ≥ 140/90 mmHg) (27), diabetes (fasting glycaemia≥ 1.26 g/l (7.0 mmol/l) (28), hyperlipidemia (self-report of physician diagnosis), obesity (Body Mass Index≥ 30) obtained through the existing medical records (29) and self-perceived health (30) evaluated by a three state single question], lifestyle habits including smoking, physical activity (Several times a week = high, Once a week = medium, Once a month or Less often = low) (31), quality of sleep (evaluated by a three state single question) (13), and finally, to gather data on depression and self-efficacy, we used a Geriatric Depression Scale (GDS≤ 8), and a General Self-Efficacy Beliefs Scale (GSE-10), respectively. The validation of the Iranian version of GDS revealed its good reliability with Cronbach’s coefficients reaching to 92%, also, the ROC analysis showed that cut-off point of 8 with sensitivity of 0.9 and specificity of 0.83 was the most desirable cut point for the Iranian version of GDS (32).…”

Longitudinal assessment of the health-related quality of life among older people with diabetes: results of a nationwide study in New Zealand

“…Similarly, in New Zealand, the prevalence of DM has been steadily growing over the last 30 years [3,4] with Māori and Pacific populaitions both disproportionally affected [5] and experaince higher diabetesrelated mortality in later life [4]. Indeed, Type 2 diabetes is an important consideration for older adults, who are at increased risk in terms of onset and disease management due to age-related changes in metabolism and who represent a considerable number of patients [6]. Indeed, disease-related complications, poorly controlled cardiovascular risk, impaired cognitive function, loss of mobility, increased dependency and service use are more common in older adults with diabetes [6].…”

Nutritional Issues and Nutrition Support in Older Home Care Patients in the City of Zagreb

“…Diabetes mellitus was the third most prevalent disease in the study sample. Chentli et al state that, on average, 20% of elderly people suff er from diabetes mellitus, and that another 20% suff er from the disease but have not been diagnosed 13 . Data on this elderly population show that 50% of all bone fractures are femoral fractures.…”