Diabetes en personas mayores: prevalencia, incidencia y su asociación con la mortalidad general a medio y largo plazo

• Autores: Mercedes Sánchez Martínez, Augusto Blanco, María Victoria Castell Alcalá, Alicia Gutiérrez Misis, Juan Ignacio González Montalvo, M. Victoria Zunzunegui Pastor, Ángel Otero Puime
• Localización: Atención primaria: Publicación oficial de la Sociedad Española de Familia y Comunitaria, ISSN 0212-6567, Vol. 46, Nº. 7, 2014, págs. 376-384
• Idioma: español
• Títulos paralelos:
  • Diabetes in older people: Prevalence, incidence and its association with medium- and long-term mortality from all causes
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• Resumen

  • Objective To estimate the prevalence and incidence of self-reported diabetes and to study its association with medium- and long-term mortality from all causes in persons =65 years.

    Design A population-based cohort study begun in 1993.

    Setting �Envejecer en Leganés� cohort (Madrid).

    Participants A random sample of persons =65 years (n = 1277 in the 1993 baseline sample).

    Methods Participants were classified as having diabetes if they so reported and had consulted a physician for this reason within the last year. Diabetes history was categorized in <10 and =10 years in 1993. Incidence density was calculated in 2-year periods in non-diabetic individuals (1965 persons/2 years). Vital status was recorded on 31 December 2011. The association between diabetes history =10 years and mortality at 6 and 18 years follow-up was studied by the Kaplan�Meier and Cox regression analyses after adjusting for age, sex, heart disease and comorbidity.

    Results The prevalence of self-reported diabetes rose from 10.3% in 1993 to 16.1% in 1999 (p = 0.001) and was higher in women than men (p = 0.05). Total incidence density was 2.6 cases/100 persons/2 years (95% CI: 2.0�3.3). Medium- and long-term mortality was higher in persons with diabetes history =10 years than in non-diabetic individuals (HR: 2.0; 95% CI: 1.2�3.3 and HR: 1.7; 95% CI: 1.1�2.5, respectively). In diabetics with history <10 years the HR was 1.3 (95% CI: 0.9�1.9) and HR: 1.5 (95% CI: 1.2�1.9, respectively).

    Conclusions Although diabetes is clearly associated with increased risk of mortality, it is significant only for patients with =10 years� history of diabetes.