%0 Journal Article %J J Gen Intern Med %D 2011 %T Geriatric conditions develop in middle-aged adults with diabetes. %A Christine T Cigolle %A Pearl G. Lee %A Kenneth M. Langa %A Lee, Yuo-Yu %A Zhiyi Tian %A Caroline S Blaum %K Accidental Falls %K Age Factors %K Aged %K Aged, 80 and over %K Aging %K Diabetes Mellitus %K Dizziness %K Female %K Geriatric Assessment %K Health Status %K Health Surveys %K Humans %K Longitudinal Studies %K Male %K Middle Aged %K pain %K Urinary incontinence %X

BACKGROUND: Geriatric conditions, collections of symptoms common in older adults and not necessarily associated with a specific disease, increase in prevalence with advancing age. These conditions are important contributors to the complex health status of older adults. Diabetes mellitus is known to co-occur with geriatric conditions in older adults and has been implicated in the pathogenesis of some conditions.

OBJECTIVE: To investigate the prevalence and incidence of geriatric conditions in middle-aged and older-aged adults with diabetes.

DESIGN: Secondary analysis of nationally-representative, longitudinal health interview survey data (Health and Retirement Study waves 2004 and 2006).

PARTICIPANTS: Respondents 51 years and older in 2004 (n=18,908).

MAIN MEASURES: Diabetes mellitus. Eight geriatric conditions: cognitive impairment, falls, incontinence, low body mass index, dizziness, vision impairment, hearing impairment, pain.

KEY RESULTS: Adults with diabetes, compared to those without, had increased prevalence and increased incidence of geriatric conditions across the age spectrum (p< 0.01 for each age group from 51-54 years old to 75-79 years old). Differences between adults with and without diabetes were most marked in middle-age. Diabetes was associated with the two-year cumulative incidence of acquiring new geriatric conditions (odds ratio, 95% confidence interval: 1.8, 1.6-2.0). A diabetes-age interaction was discovered: as age increased, the association of diabetes with new geriatric conditions decreased.

CONCLUSIONS: Middle-aged, as well as older-aged, adults with diabetes are at increased risk for the development of geriatric conditions, which contribute substantially to their morbidity and functional impairment. Our findings suggest that adults with diabetes should be monitored for the development of these conditions beginning at a younger age than previously thought.

%B J Gen Intern Med %I 26 %V 26 %P 272-9 %8 2011 Mar %G eng %N 3 %L newpubs20110418_Cigolle.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/20878496?dopt=Abstract %2 PMC3043187 %4 geriatric conditions/diabetes/cognitive Impairment/falls/Incontinence/Vision Disorders/Hearing Disorders %$ 24780 %R 10.1007/s11606-010-1510-y %0 Journal Article %J Ann Intern Med %D 2007 %T Geriatric conditions and disability: the Health and Retirement Study. %A Christine T Cigolle %A Kenneth M. Langa %A Mohammed U Kabeto %A Zhiyi Tian %A Caroline S Blaum %K Accidental Falls %K Activities of Daily Living %K Age Factors %K Aged %K Aged, 80 and over %K Body Mass Index %K Chronic disease %K Cognition Disorders %K Comorbidity %K Cross-Sectional Studies %K Disability Evaluation %K Dizziness %K Female %K Geriatric Assessment %K Geriatrics %K Hearing Disorders %K Humans %K Male %K Prevalence %K Retirement %K Urinary incontinence %K Vision Disorders %X

BACKGROUND: Geriatric conditions, such as incontinence and falling, are not part of the traditional disease model of medicine and may be overlooked in the care of older adults. The prevalence of geriatric conditions and their effect on health and disability in older adults has not been investigated in population-based samples.

OBJECTIVE: To investigate the prevalence of geriatric conditions and their association with dependency in activities of daily living by using nationally representative data.

DESIGN: Cross-sectional analysis.

SETTING: Health and Retirement Study survey administered in 2000.

PARTICIPANTS: Adults age 65 years or older (n = 11 093, representing 34.5 million older Americans) living in the community and in nursing homes.

MEASUREMENTS: Geriatric conditions (cognitive impairment, falls, incontinence, low body mass index, dizziness, vision impairment, hearing impairment) and dependency in activities of daily living (bathing, dressing, eating, transferring, toileting).

RESULTS: Of adults age 65 years or older, 49.9% had 1 or more geriatric conditions. Some conditions were as prevalent as common chronic diseases, such as heart disease and diabetes. The association between geriatric conditions and dependency in activities of daily living was strong and significant, even after adjustment for demographic characteristics and chronic diseases (adjusted risk ratio, 2.1 [95% CI, 1.9 to 2.4] for 1 geriatric condition, 3.6 [CI, 3.1 to 4.1] for 2 conditions, and 6.6 [CI, 5.6 to 7.6] for > or =3 conditions).

LIMITATIONS: The study was cross-sectional and based on self-reported data. Because measures were limited by the survey questions, important conditions, such as delirium and frailty, were not assessed. Survival biases may influence the estimates.

CONCLUSIONS: Geriatric conditions are similar in prevalence to chronic diseases in older adults and in some cases are as strongly associated with disability. The findings suggest that geriatric conditions, although not a target of current models of health care, are important to the health and function of older adults and should be addressed in their care.

%B Ann Intern Med %I 147 %V 147 %P 156-64 %8 2007 Aug 07 %G eng %N 3 %L newpubs20071002_Cigolle_etal.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/17679703?dopt=Abstract %4 ADL and IADL Impairments/Geriatrics/Chronic Disease/Health care %$ 18010 %R 10.7326/0003-4819-147-3-200708070-00004