title: Determinants of new-onset diabetes in older adults—Results of a national cohort study.
abstract: OBJECTIVE
  Diabetes mellitus is prevalent in many countries around the world, but the potential causal factors are not clearly known. We attempted to determine the risk factors for new-onset diabetes in ≥53-year old Taiwanese.
  
  
  METHODS
  We analyzed the 1999 and 2003 datasets of the Taiwan Longitudinal Survey on Aging (TLSA). We performed logistic regression analyses to determine the cross-sectional and longitudinal (1999-2003) associations of the sociodemographic, lifestyle, and health-related variables with diabetes and new-onset diabetes, respectively. We excluded those who were diabetic at baseline in the longitudinal analysis.
  
  
  RESULTS
  Results of the cross-sectional analysis showed that higher weight, past betel-quid chewing, IADL dependency, hypertension, heart disease, chronic kidney disease and depressive symptoms were positively associated with diabetes while alcohol drinking was negatively associated with diabetes. Longitudinal analysis showed that excessive weight, physical inactivity, depressive symptoms, and hypertension were associated with increased likelihood of new-onset diabetes while higher physical activity was associated with reduced likelihood of new-onset diabetes. Cigarette-smoking and moderate alcohol drinking showed no clear impacts on new-onset diabetes in older Taiwanese.
  
  
  CONCLUSIONS
  Results show that excessive weight, physical inactivity, hypertension and depressive symptoms are the major risk factors for new-onset diabetes for both Eastern and Western populations, whereas smoking and alcohol drinking have varying impacts among these populations. Better understanding of these relationships should be helpful for planning effective health promotion strategies for reducing the risk of new-onset diabetes in older adults.
authors.affiliation: Department of Healthcare Administration, Asia University, Wufeng, Taichung, Taiwan; Department of Health Services Management, School of Public Health, China Medical, University, Taichung, Taiwan. Electronic address: atsai@umich.edu.
authors.forename: Alan C
authors.initials: AC
authors.lastname: Tsai
authors.affiliation: Department of Healthcare Administration, Asia University, Wufeng, Taichung, Taiwan; Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan. Electronic address: lee2236@gmail.com.
authors.forename: Shu-Hui
authors.initials: SH
authors.lastname: Lee
mesh_terms: D000368:Aged; D000375:Aging; D000428:Alcohol Drinking / Q000009:adverse effects; D044466:Asian People; D015992:Body Mass Index; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology*; D008019:Life Style; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D050177:Overweight / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology
keywords: Elderly; Inactivity; New-onset diabetes; Overweight/obesity; Physical activity