Age of diagnosis of diabetes may be associated with different long term outcomes

1. Age at diabetes diagnosis among adult populations was associated with varying outcomes.

2. Younger age groups were associated with an elevated risk of heart disease, stroke, disability, cognitive impairment, and all-cause mortality compared to older age groups.

Evidence Rating Level: 2 (Good)

Older adults with diabetes are a unique and distinct patient population although these individuals are often treated similarly to middle-aged adults. There is minimal information currently known about the effect of age at diagnosis of diabetes on long-term outcomes among older adults. In this retrospective cohort study, 39,093 participants older the age of 50 were assessed for age at diabetes diagnosis, and several outcomes including heart disease, stroke, disability, cognitive impairment, and mortality. Outcomes were compared with a matched non-diabetes control group. Interestingly, the results showed that for participants diagnosed between the ages of 50 to 59, diabetes was associated with an increased risk of heart disease (HR 1.66, 95%CI 1.40-1.96), stroke (HR 1.64, 95%CI 1.30-2.07), disability (HR 2.08, 95%CI 1.59-2.72), cognitive impairment (HR 1.30, 95%CI 1.05-1.61), and mortality (HR 1.49, 95%CI 1.29-1.71) compared to their matched controls. Individuals diagnosed at age 70 and older only had an elevated risk of mortality compared to matched controls (HR 1.08, 95%CI 1.01-1.17). In conclusion, this study suggests that an earlier diagnosis of diabetes is associated with worse outcomes though the mechanism behind this is not elucidated. This study had several strengths including the large sample size, which allows the study to be more generalized to the broader population. Additionally, the methodology examined current age, age at diagnosis, and duration of diabetes in their assessment of long-term outcomes, which enable stronger correlations to be made. However, further studies should be conducted to explore the long-term effects of age of diabetes diagnosis on health outcomes in older adults.

Click to read the study in JAMA Network Open

Image: PD

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