title: Health-related quality of life (HRQOL) decreases independently of chronic conditions and geriatric syndromes in older adults with diabetes: the Fujiwara-kyo Study.
abstract: BACKGROUND
  Very few studies have investigated the association between diabetes and impaired health-related quality of life (HRQOL) in older adults, independent of chronic conditions and geriatric syndromes.
  
  
  METHODS
  We conducted a self-administered questionnaire survey and structured interviews with 3946 people aged 65 years or older to obtain medical histories of diabetes, chronic conditions, and geriatric syndromes. Blood tests were performed to measure glycated hemoglobin (HbA1c) and plasma glucose levels. HRQOL was evaluated using the Medical Outcomes Study 36-Item Short-Form General Health Survey (SF-36), and multiple logistic regression analysis was used to calculate adjusted odds ratios and 95% CIs for low HRQOL.
  
  
  RESULTS
  A total of 3521 participants had not received a physician diagnosis of diabetes. Of these, 2345 participants with an HbA1c less than 5.7% were defined as the referent group. As compared with the referent group, 1029 participants with an HbA1c of at least 5.7% but less than 6.5% showed no significant decrease in QOL on the SF-36 physical, mental, and role component summaries, after adjustment for chronic conditions, geriatric syndromes, and other potential confounders. However, 572 patients who had received a physician diagnosis of diabetes and/or had an HbA1c of 6.5% or higher had a significantly higher adjusted odds ratio (1.48; 95% CI, 1.18-1.84) for the low physical component summary. No significant differences in relation to glycemic control, treatment regimen, or diabetes duration were found in any of the 3 component summaries among the 425 participants who were undergoing diabetes treatment.
  
  
  CONCLUSIONS
  Older Japanese adults with diabetes had decreased physical QOL, independent of chronic conditions and geriatric syndromes.
authors.affiliation: Department of Community Health and Epidemiology, Nara Medical University School of Medicine.
authors.forename: Satoko
authors.initials: S
authors.lastname: Nezu
authors.forename: Nozomi
authors.initials: N
authors.lastname: Okamoto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Morikawa
authors.forename: Keigo
authors.initials: K
authors.lastname: Saeki
authors.forename: Kenji
authors.initials: K
authors.lastname: Obayashi
authors.forename: Kimiko
authors.initials: K
authors.lastname: Tomioka
authors.forename: Masayo
authors.initials: M
authors.lastname: Komatsu
authors.forename: Junko
authors.initials: J
authors.lastname: Iwamoto
authors.forename: Norio
authors.initials: N
authors.lastname: Kurumatani
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D016022:Case-Control Studies; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000503:physiopathology*; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006442:Glycated Hemoglobin / Q000032:analysis; D006306:Health Surveys; D006801:Humans; D057187:Independent Living; D007564:Japan; D008297:Male; D036301:Qualitative Research; D011788:Quality of Life; D013577:Syndrome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human