Skip to main content
PMC home page
CMAJ : Canadian Medical Association Journal logoLink to CMAJ : Canadian Medical Association Journal
. 2000 Mar 21;162(6):769–772.

Incidence and outcomes of diabetes mellitus in elderly people: report from the Canadian Study of Health and Aging

K Rockwood 1, E Awalt 1, C MacKnight 1, I McDowell 1
PMCID: PMC1231267  PMID: 10750461

Abstract

BACKGROUND: The epidemiology of diabetes in elderly people is not well understood. The purpose of this study was to estimate the incidence of diabetes mellitus among elderly people in Canada and the relative risks of death and admission to an institution among elderly diabetic patients. METHODS: The study was a secondary analysis of data for a community-dwelling sample from the Canadian Study of Health and Aging, a nationwide representative cohort study of 9008 elderly people (65 years of age or older at baseline) in Canada. Diabetes was identified primarily by self-reporting, and a clinician's diagnosis and the presence of treatments for diabetes were used to identify diabetic patients who did not report that they had the condition. RESULTS: The reliability of self-reported diabetes (the kappa statistic) was 0.85. The estimated annual incidence of diabetes was 8.6 cases per thousand for elderly Canadians. Incidence decreased with age, from 9.5 for subjects 65-74 years of age, to 7.9 for those 75-84 years of age and then to 3.1 for those 85 years of age and older. Diabetes was associated with death (relative risk 1.87, 95% confidence interval 1.59-2.19) and admission to an institution (relative risk 1.58, 95% confidence interval 1.28-1.94). INTERPRETATION: Diabetes mellitus is common among elderly people, but the incidence declines among the very old.

Full Text

The Full Text of this article is available as a PDF (227.1 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blanchard J. F., Ludwig S., Wajda A., Dean H., Anderson K., Kendall O., Depew N. Incidence and prevalence of diabetes in Manitoba, 1986-1991. Diabetes Care. 1996 Aug;19(8):807–811. doi: 10.2337/diacare.19.8.807. [DOI] [PubMed] [Google Scholar]
  2. Garancini M. P., Gobbi C., Errera A., Sergi A., Gallus G. Age-specific incidence and duration of known diabetes. The Cremona Study. Diabetes Care. 1996 Nov;19(11):1279–1282. doi: 10.2337/diacare.19.11.1279. [DOI] [PubMed] [Google Scholar]
  3. Harris M. I. Undiagnosed NIDDM: clinical and public health issues. Diabetes Care. 1993 Apr;16(4):642–652. doi: 10.2337/diacare.16.4.642. [DOI] [PubMed] [Google Scholar]
  4. Hogan D. B., Ebly E. M., Rockwood K. Weight, blood pressure, osmolarity, and glucose levels across various stages of Alzheimer's disease and vascular dementia. Dement Geriatr Cogn Disord. 1997 May-Jun;8(3):147–151. doi: 10.1159/000106623. [DOI] [PubMed] [Google Scholar]
  5. Hébert R., Bravo G., Korner-Bitensky N., Voyer L. Refusal and information bias associated with postal questionnaires and face-to-face interviews in very elderly subjects. J Clin Epidemiol. 1996 Mar;49(3):373–381. doi: 10.1016/0895-4356(95)00527-7. [DOI] [PubMed] [Google Scholar]
  6. Jarrett R. J., McCartney P., Keen H. The Bedford survey: ten year mortality rates in newly diagnosed diabetics, borderline diabetics and normoglycaemic controls and risk indices for coronary heart disease in borderline diabetics. Diabetologia. 1982 Feb;22(2):79–84. doi: 10.1007/BF00254833. [DOI] [PubMed] [Google Scholar]
  7. Johnson K. C., Graney M. J., Applegate W. B., Kitabchi A. E., Runyan J. W., Shorr R. I. Prevalence of undiagnosed non-insulin-dependent diabetes mellitus and impaired glucose tolerance in a cohort of older persons with hypertension. J Am Geriatr Soc. 1997 Jun;45(6):695–700. doi: 10.1111/j.1532-5415.1997.tb01472.x. [DOI] [PubMed] [Google Scholar]
  8. Leibson C. L., O'Brien P. C., Atkinson E., Palumbo P. J., Melton L. J., 3rd Relative contributions of incidence and survival to increasing prevalence of adult-onset diabetes mellitus: a population-based study. Am J Epidemiol. 1997 Jul 1;146(1):12–22. doi: 10.1093/oxfordjournals.aje.a009187. [DOI] [PubMed] [Google Scholar]
  9. Manton K. G., Stallard E., Liu K. Forecasts of active life expectancy: policy and fiscal implications. J Gerontol. 1993 Sep;48(Spec No):11–26. doi: 10.1093/geronj/48.special_issue.11. [DOI] [PubMed] [Google Scholar]
  10. Muggeo M., Verlato G., Bonora E., Bressan F., Girotto S., Corbellini M., Gemma M. L., Moghetti P., Zenere M., Cacciatori V. The Verona diabetes study: a population-based survey on known diabetes mellitus prevalence and 5-year all-cause mortality. Diabetologia. 1995 Mar;38(3):318–325. doi: 10.1007/BF00400637. [DOI] [PubMed] [Google Scholar]
  11. Mølbak A. G., Christau B., Marner B., Borch-Johnsen K., Nerup J. Incidence of insulin-dependent diabetes mellitus in age groups over 30 years in Denmark. Diabet Med. 1994 Aug-Sep;11(7):650–655. doi: 10.1111/j.1464-5491.1994.tb00327.x. [DOI] [PubMed] [Google Scholar]
  12. Rockwood K., Ebly E., Hachinski V., Hogan D. Presence and treatment of vascular risk factors in patients with vascular cognitive impairment. Arch Neurol. 1997 Jan;54(1):33–39. doi: 10.1001/archneur.1997.00550130019010. [DOI] [PubMed] [Google Scholar]
  13. Rockwood K., Stolee P., McDowell I. Factors associated with institutionalization of older people in Canada: testing a multifactorial definition of frailty. J Am Geriatr Soc. 1996 May;44(5):578–582. doi: 10.1111/j.1532-5415.1996.tb01446.x. [DOI] [PubMed] [Google Scholar]
  14. Rockwood K., Stolee P., Robertson D., Shillington E. R. Response bias in a health status survey of elderly people. Age Ageing. 1989 May;18(3):177–182. doi: 10.1093/ageing/18.3.177. [DOI] [PubMed] [Google Scholar]
  15. Rockwood K., Tan M., Phillips S., McDowell I. Prevalence of diabetes mellitus in elderly people in Canada: report from the Canadian Study of Health and Aging. Age Ageing. 1998 Sep;27(5):573–577. doi: 10.1093/ageing/27.5.573. [DOI] [PubMed] [Google Scholar]
  16. Ruwaard D., Gijsen R., Bartelds A. I., Hirasing R. A., Verkleij H., Kromhout D. Is the incidence of diabetes increasing in all age-groups in The Netherlands? Results of the second study in the Dutch Sentinel Practice Network. Diabetes Care. 1996 Mar;19(3):214–218. doi: 10.2337/diacare.19.3.214. [DOI] [PubMed] [Google Scholar]
  17. Shin C. S., Lee H. K., Koh C. S., Kim Y. I., Shin Y. S., Yoo K. Y., Paik H. Y., Park Y. S., Yang B. G. Risk factors for the development of NIDDM in Yonchon County, Korea. Diabetes Care. 1997 Dec;20(12):1842–1846. doi: 10.2337/diacare.20.12.1842. [DOI] [PubMed] [Google Scholar]
  18. Simmons D., Williams D. R. Diabetes in the elderly: an under-diagnosed condition. Diabet Med. 1993 Apr;10(3):264–266. doi: 10.1111/j.1464-5491.1993.tb00055.x. [DOI] [PubMed] [Google Scholar]
  19. Stengård J. H., Tuomilehto J., Pekkanen J., Kivinen P., Kaarsalo E., Nissinen A., Karvonen M. J. Diabetes mellitus, impaired glucose tolerance and mortality among elderly men: the Finnish cohorts of the Seven Countries Study. Diabetologia. 1992 Aug;35(8):760–765. doi: 10.1007/BF00429097. [DOI] [PubMed] [Google Scholar]
  20. Teng E. L., Chui H. C. The Modified Mini-Mental State (3MS) examination. J Clin Psychiatry. 1987 Aug;48(8):314–318. [PubMed] [Google Scholar]
  21. Tsuji I., Whalen S., Finucane T. E. Predictors of nursing home placement in community-based long-term care. J Am Geriatr Soc. 1995 Jul;43(7):761–766. doi: 10.1111/j.1532-5415.1995.tb07046.x. [DOI] [PubMed] [Google Scholar]
  22. Vanderpump M. P., Tunbridge W. M., French J. M., Appleton D., Bates D., Rodgers H., Evans J. G., Clark F., Tunbridge F., Young E. T. The incidence of diabetes mellitus in an English community: a 20-year follow-up of the Whickham Survey. Diabet Med. 1996 Aug;13(8):741–747. doi: 10.1002/(SICI)1096-9136(199608)13:8<741::AID-DIA173>3.0.CO;2-4. [DOI] [PubMed] [Google Scholar]
  23. Vilbergsson S., Sigurdsson G., Sigvaldason H., Hreidarsson A. B., Sigfusson N. Prevalence and incidence of NIDDM in Iceland: evidence for stable incidence among males and females 1967-1991--the Reykjavik Study. Diabet Med. 1997 Jun;14(6):491–498. doi: 10.1002/(SICI)1096-9136(199706)14:6<491::AID-DIA365>3.0.CO;2-1. [DOI] [PubMed] [Google Scholar]
  24. Wilson P. W., Anderson K. M., Kannel W. B. Epidemiology of diabetes mellitus in the elderly. The Framingham Study. Am J Med. 1986 May 16;80(5A):3–9. doi: 10.1016/0002-9343(86)90532-2. [DOI] [PubMed] [Google Scholar]
  25. Worrall G., Moulton N. The ratio of diagnosed to undiagnosed diabetes in patients 40 years and older. Can J Public Health. 1992 Sep-Oct;83(5):379–381. [PubMed] [Google Scholar]

Articles from CMAJ: Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES