title: Older Adults Reporting More Diabetes Mellitus Care Have Greater 9-Year Survival.
abstract: OBJECTIVE
  To determine whether receiving more recommended diabetes mellitus (DM) care processes (tests and screenings) would translate into better 9-year survival for middle-aged and older adults.
  
  
  METHODS
  Longitudinal mortality analysis using the Health and Retirement Study Diabetes Mailout Survey.
  
  
  METHODS
  Health and Retirement Study (HRS).
  
  
  METHODS
  Individuals aged 51 and older (n = 1,879; mean age 68.8 ± 8.7, 26.5% aged ≥75) with self-reported DM who completed the Diabetes Mailout Survey and the core 2002 HRS survey.
  
  
  METHODS
  A composite measure of five self-reported diabetes mellitus care process measures were dichotomized as greater (3-5 processes) versus fewer (0-2 processes) care processes provided. Cox proportional hazards models were used to test relationships between reported measures and mortality, controlling for sociodemographic characteristics, function, comorbidities, geriatric conditions, and insulin use.
  
  
  RESULTS
  Prevalence of self-reported care processes was 80.1% for glycosylated hemoglobin test, 75.9% for urine test, 67.5% for eye examination, 67.7% for aspirin counseling, and 48.2% for diabetes education. In 9 years, 32.1% respondents died. Greater care correlated with 24% lower risk of dying (adjusted hazard ratio = 0.76, 95% confidence interval = 0.64-0.91) at 9-year follow up. When respondents were age-stratified (≥75 vs <75) longer survival was statistically significant only in the older age group.
  
  
  CONCLUSIONS
  Although it is not possible to account for differences in adherence to care that may also affect survival, this study demonstrates that monitoring of and counseling about types of DM care processes are associated with long-term survival benefit even in individuals aged 75 and older with DM.
authors.affiliation: Division of Geriatric Medicine and Palliative Care, Department of Medicine, School of Medicine, New York University, New York, New York.
authors.forename: Benjamin H
authors.initials: BH
authors.lastname: Han
authors.affiliation: Division of Geriatric Medicine and Palliative Care, Department of Medicine, School of Medicine, New York University, New York, New York.
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Blaum
authors.affiliation: Division of Geriatric Medicine and Palliative Care, Department of Medicine, School of Medicine, New York University, New York, New York.
authors.forename: Rosie E
authors.initials: RE
authors.lastname: Ferris
authors.affiliation: Division of Geriatric and Palliative Medicine, Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor, Michigan.|Geriatric Research, Education and Clinical Center, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.
authors.forename: Lillian C
authors.initials: LC
authors.lastname: Min
authors.affiliation: Division of Geriatric and Palliative Medicine, Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor, Michigan.|Geriatric Research, Education and Clinical Center, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.
authors.forename: Pearl G
authors.initials: PG
authors.lastname: Lee
keywords: diabetes mellitus; older adults; process of care measures; quality of care