Course, Prognosis and Mortality in Japanese Elderly Diabetes Mellitus —A Seven Year Follow-up Study—

Abstract

Course, prognosis and mortality in Japanese elderly diabetes mellitus were studied using a 7 year follow-up study of 424 elderly diabetics whose ages were 60 years old or more (mean age: 72.6 ± 6.2, 144 males: 280 females) at baseline. The relationships between clinical findings at baseline and prognosis, causes of death and onset of ischemic heart disease during the follow-up period were also studied. A total of 133 (31%) deaths were observed during the follow-up period. Risk factors present at baseline which significantly influenced the patients’ prognosis included age, male gender, previous cerebro-vascular disease, body mass index, pharmacological treatment of diabetes and persistent proteinuria. These factors were also related to the causes of death among the patients. Cardio-vascular disease deaths (n=66, 50%) tended to increase in patients with a relatively higher age, male gender, previous ischemic heart disease and persistent proteinuria. Malignant neoplasm deaths (n=28, 21%) tended to increase in patients with relatively higher age and previous cerebro- vascular disease. Furthermore, infectious deaths (n=16, 12%) were relatively increased in patients with a relatively higher age, male gender, previous cerebro-vascular disease, relatively lower body mass index and higher fasting plasma glucose levels. Among various causes for cardio-vascular disease deaths, ischemic heart disease (n=40) was the leading cause of death. Therefore, risk factors for ischemic heart disease including both nonfatal (n=42) and fatal (n=40) ischemic heart disease were examined. Previous ischemic heart disease, rela-tively higher systolic blood pressure, higher glycohemo-globin A1 levels and higher serum cholesterol levels were significant and independent risk factors for ischemic heart disease in elderly diabetics. The latter three factors were also significant risk factors for ischemic heart disease in patients without previous ischemic heart disease at baseline. From these results, it is possible to conclude that, even in the elderly, diabetes mellitus should be treated as carefully as in young or middle-aged cases. © 1993, The Japan Geriatrics Society. All rights reserved.