title: The dynamics of life expectancy over the last six decades in elderly people with diabetes.
abstract: OBJECTIVE
  To investigate the historical changes in survival with diabetes in elderly people with diabetes.
  
  
  METHODS
  We analyzed 6504 deaths (44.5% males) registered in a large urban population, aged ≥65 years, and deceased between 1943 and 2009. We split the analysis into three time periods according to year of death: 1943-1965, 1966-1988 and 1989-2009. The parallel changes in the corresponding general population were available.
  
  
  RESULTS
  The mean age at diabetes onset was 70.8 ± 4.7 years, with mean disease duration at death 7.5 ± 5 years, and mean age at death 78.3 ± 5.9 years. The mean survival loss due to diabetes (expected minus observed survival) was 4.5 ± 5.1 years (4.9 ± 5.1 years for females versus 4.1 ± 5.2 years for males, p<0.001). The mean disease duration at death was 6.4 ± 5.7 years in the period 1943-1965, followed by a significant (p=0.019) rise to 7 ± 5 years in 1966-1988, and 8.3 ± 4.9 years (p<0.001) in 1989-2009. There was a significant increase in coronary heart disease and stroke, and a significant decrease in infections and end-stage renal disease as causes of death.
  
  
  CONCLUSIONS
  We found a significant increase in age at onset and survival with diabetes leading to a significant increase in age at death. Females had a higher survival loss due to diabetes compared with males.
authors.affiliation: N. Paulescu National Institute of Diabetes, Nutrition and Metabolic Diseases, Bucharest, Romania. drsorin@yahoo.com
authors.forename: S
authors.initials: S
authors.lastname: Ioacara
authors.forename: C
authors.initials: C
authors.lastname: Guja
authors.forename: S
authors.initials: S
authors.lastname: Fica
authors.forename: C
authors.initials: C
authors.lastname: Ionescu-Tirgoviste
mesh_terms: D017668:Age of Onset; D000368:Aged; D002423:Cause of Death; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D013997:Time Factors