Correlates of Quality of Life in Older Adults With Diabetes
Open accessAbstract
OBJECTIVE: To evaluate associations between health-related quality of life (HRQL) and geriatric syndromes, diabetes complications, and hypoglycemia in older adults with diabetes. RESEARCH DESIGN AND METHODS: A race-stratified random sample of 6,317 adults with type 2 or type 1 diabetes, aged 60 to 75 years, enrolled in Kaiser Permanente Northern California, who completed a survey that included a HRQL instrument based on the Short Form 8-item health survey. Administrative records were used to ascertain diagnoses of geriatric syndromes, diabetes complications, and hypoglycemia. Associations were estimated between HRQL and exposures in exposure-specific and combined exposure models (any syndrome, any complication, or hypoglycemia). Conservatively, differences of ≥3 points were considered the minimally important difference in HRQL scores. RESULTS: HRQL was lower with nearly all exposures of interest. The lowest physical HRQL was associated with amputation. In combined exposure models, geriatric syndromes (−5.3 [95% CI −5.8 to −4.8], P < 0.001) and diabetes complications (−3.5 [−4.0 to −2.9], P < 0.001) were associated with lower physical HRQL. The lowest mental HRQL was associated with depression, underweight (BMI <18 kg/m2), amputation, and hypoglycemia. In combined exposure models, only hypoglycemia was associated with lower mental HRQL (−4.0 [−7.0 to −1.1], P = 0.008). CONCLUSIONS: Geriatric syndromes and hypoglycemia are associated with lower HRQL to a comparable degree as diabetes complications. Addressing geriatric syndromes and avoiding hypoglycemia should be given as high a priority as preventing diabetes complications in older adults with diabetes.
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These geriatric syndromes and polypharmacy may impact older adults' diabetes self-management abilities and quality of life if left unaddressed.
“These conditions may impact older adults' diabetes self-management abilities and quality of life if left unaddressed (2,6,7).”
From 13. Older Adults: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [7]
The Conclusions report that geriatric syndromes are associated with lower health-related quality of life in older adults with diabetes and recommend addressing them. The paper does not establish that polypharmacy affects quality of life or that either polypharmacy or the studied geriatric syndromes impairs diabetes self-management abilities. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThese conditions may impact older adults' diabetes self-management abilities and quality of life if left unaddressed.
“These conditions may impact older adults' diabetes self-management abilities and quality of life if left unaddressed (2,6,7).”
From 13. Older Adults: Standards of Care in Diabetes—2025 (2025) · cites this paper as [7]
The Conclusions report that geriatric syndromes, diabetes complications, and hypoglycemia are associated with lower health-related quality of life in older adults with diabetes, and recommend addressing these conditions. The paper does not establish that leaving them unaddressed impairs diabetes self-management abilities; its outcome was quality of life, and the study was cross-sectional. (LLM, conf=0.87)
Experimental — accuracy not yet measuredThese conditions may affect older adults' diabetes self-management abilities and quality of life, particularly if unaddressed.
“These conditions may affect older adults’ diabetes self-management abilities and quality of life, particularly if unaddressed, and older adults with diabetes often require greater caregiver support than those without diabetes (2,9–11).”
From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [10]
The Conclusions (page not provided) associate geriatric syndromes, diabetes complications, and hypoglycemia with lower health-related quality of life in older adults with diabetes and recommend addressing them. The paper does not establish that these conditions affect diabetes self-management abilities; that part of the claim is unsupported. (LLM, conf=0.86)
Experimental — accuracy not yet measuredImpaired social support and reduced access to long-term services and support may reduce quality of life and increase risk of functional dependency in older adults with diabetes.
“Impaired social support and reduced access to long-term services and support may reduce these individuals' quality of life and increase the risk of functional dependency (7).”
From 13. Older Adults: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [7]
The Conclusions report that geriatric syndromes, diabetes complications, and hypoglycemia are associated with lower health-related quality of life in older adults with diabetes. The Methods identify those exposures, but neither they nor the additional passages found by searching for social support, long-term services, and functional dependence address whether impaired support or reduced service access lowers quality of life or increases functional dependency. (LLM, conf=0.76)
Experimental — accuracy not yet measuredInadequate social support and reduced access to long-term services and support may reduce quality of life and increase the risk of functional dependency.
“Inadequate social support and reduced access to long-term services and support may reduce these individuals' quality of life and increase the risk of functional dependency (7).”
From 13. Older Adults: Standards of Care in Diabetes—2025 (2025) · cites this paper as [7]
The Conclusions report that geriatric syndromes and diabetes complications are associated with lower health-related quality of life in older adults with diabetes. The passages searched for social support, long-term services, and functional dependency do not address whether inadequate support or reduced service access affects either outcome. (LLM, conf=0.76)
Experimental — accuracy not yet measured
Older adults with diabetes often require greater caregiver support than those without diabetes.
“These conditions may affect older adults’ diabetes self-management abilities and quality of life, particularly if unaddressed, and older adults with diabetes often require greater caregiver support than those without diabetes (2,9–11).”
From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [10]
The Results describe a cohort of older adults with diabetes, and the Conclusions discuss associations between geriatric syndromes and quality of life; neither reports caregiver-support needs. The introduction mentions comparisons with adults without diabetes only for quality of life. Searches for caregiver support and assistance with self-management found no passage addressing the claimed comparison. (LLM, conf=0.75)
Experimental — accuracy not yet measuredInadequate social support and reduced access to long-term services and support may reduce quality of life and increase the risk of functional dependency in older adults with diabetes.
“Inadequate social support and reduced access to long-term services and support may reduce these individuals’ quality of life and increase the risk of functional dependency”
From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [10]
The Conclusions report that geriatric syndromes, diabetes complications, and hypoglycemia are associated with lower health-related quality of life in older adults with diabetes. Searches for social support, access to long-term services, and functional dependency found no passage connecting those factors to the claimed outcomes. The paper's discussion of functional disability does not establish the attributed relationship. (LLM, conf=0.75)
Experimental — accuracy not yet measuredGeriatric syndromes occur at higher frequency in older adults with diabetes, and may affect self-care abilities and health outcomes including quality of life.
“a group of conditions termed geriatric syndromes, described below, also occur at higher frequency in older adults with diabetes, and may affect self-care abilities and health outcomes including quality of life58.”
From Diabetes in Older Adults: A Consensus Report (2012) · cites this paper as [58]
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- Authors
- Laiteerapong, N., Karter, A. J., Liu, J. Y., Moffet, H. H., Sudore, R., Schillinger, D., John, P. M., & Huang, E. S.
- Affiliations
- University of Chicago (US)
- Kaiser Permanente (US)
- San Francisco VA Medical Center (US)
- San Francisco General Hospital (US)
- Corresponding author
- Laiteerapong, Neda
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2011-07-16
- Volume
- 34
- Issue
- 8
- Pages
- 1749-1753
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3142040
- OpenAlex
- W2133108454
- Cited by
- 227
- References
- 26
- Citations by year
- 2026: 9 · 2025: 14 · 2024: 11 · 2023: 19 · 2022: 14 · 2021: 22 · 2020: 18 · 2019: 13 · 2018: 20 · 2017: 17 · 2016: 12 · 2015: 14 · 2014: 17 · 2013: 14 · 2012: 9
- FWCI
- 11.53
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Agency for Healthcare Research and Quality (T32HS000084)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK080726, P60DK20595, F32DK089973, R01DK081796, RC1DK086178, P60DK020595, R01DK065664)
- National Center for Research Resources (UL1RR024131)
- National Center for Chronic Disease Prevention and Health Promotion (1U58DP002007-02, U58 DP002007)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01-HD-46113, R01HD046113)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- health-related quality of life, older adults, diabetes mellitus, geriatric syndromes, diabetes complications, hypoglycemia, depression, underweight, amputation, type 2 diabetes, type 1 diabetes, physical function, mental health
- MeSH terms
- Aged, Aging, Diabetes Mellitus, Female, Health Surveys, Humans, Hypoglycemia, Male, Middle Aged, Quality of Life, Diabetes Complications
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