Perceptions of Quality‐of‐Life Effects of Treatments for Diabetes Mellitus in Vulnerable and Nonvulnerable Older Patients
Open accessAbstract
OBJECTIVES: To assess whether patient perceptions of treatments for diabetes mellitus differ according to clinical criteria such as limited life expectancy and functional decline (i.e., vulnerability). DESIGN: Cross‐sectional survey. SETTING: Clinics affiliated with two Chicago‐area hospitals. PARTICIPANTS: Patients aged 65 and older living with type 2 diabetes mellitus (N=332). MEASUREMENTS: Utilities (quantitative measures of preference on a scale from 0 to 1, with 0 representing a state equivalent to death and 1 representing life in perfect health) were assessed for nine hypothetical treatment states using time trade‐off questions, and patients were queried about specific concerns regarding medications. Vulnerability was defined according to the Vulnerable Elders Scale. RESULTS: Thirty‐six percent of patients were vulnerable. Vulnerable patients were older (77 vs 73) and had diabetes mellitus longer (13 vs 10 years; P <.05). Vulnerable patients reported lower utilities than nonvulnerable patients for most individual treatment states (e.g., intensive glucose control, mean 0.61 vs 0.72, P <.01), but within group variation was large for both groups (e.g., standard deviations >0.25). Although mean individual state utilities differed across groups, no significant differences were found in how vulnerable and nonvulnerable patients compared intensive and conventional treatment states (e.g., intensive vs conventional glucose control). In multivariable analyses, the association between vulnerability and individual treatment state utilities became nonsignificant except for the cholesterol pill. CONCLUSION: Older patients' preferences for intensity of treatment for diabetes mellitus vary widely and are not closely associated with vulnerability. This observation underscores the importance of involving older patients in decisions about treatment for diabetes mellitus, irrespective of clinical status.
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Older adults vary in their preferences for the intensity and mode of glucose management.
“Older adults also vary in their preferences for the intensity and mode of glucose management (54).”
From 13. Older Adults: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [54]
Older adults vary in their preferences for the intensity and mode of glucose management.
“Older adults also vary in their preferences for the intensity and mode of glucose management (64).”
From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [64]
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- Authors
- Brown, S. E. S., Meltzer, D. O., Chin, M. H., & Huang, E. S.
- Affiliations
- University of Chicago (US)
- Corresponding author
- Huang, Elbert S.
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2008-07
- Volume
- 56
- Issue
- 7
- Pages
- 1183-1190
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- PMC
- PMC2614394
- OpenAlex
- W2115976473
- Cited by
- 53
- References
- 51
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 13 · 2022: 3 · 2021: 2 · 2020: 1 · 2019: 1 · 2018: 3 · 2017: 4 · 2016: 1 · 2015: 2 · 2014: 3 · 2013: 4 · 2012: 4
- FWCI
- 1.45
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- California Health Care Foundation
- Centers for Disease Control and Prevention (P30-CD000147)
- U.S. Public Health Service (U36-CCU319276)
- National Institute on Aging (K23AG021963)
- National Institute of Diabetes and Digestive and Kidney Diseases (P60DK20595, K24DK071933, P60DK020595)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- type 2 diabetes, older adults, patient preferences, quality of life, treatment intensity, vulnerable elderly, time trade-off, utility, tight glycemic control, patient involvement in treatment decisions, medication concerns
- MeSH terms
- Aged, Chicago, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Female, Humans, Interview, Psychological, Male, Quality of Life, Surveys and Questionnaires, Geriatric Assessment, Patient Satisfaction
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