title: Limited Effectiveness of Diabetes Risk Assessment Tools in Seniors' Facility Residents.
abstract: Undiagnosed diabetes can create significant management issues for seniors.
  
  
  
  To evaluate the effectiveness of two diabetes risk surveys-the Canadian Diabetes Risk Assessment Questionnaire (CANRISK) and the Finnish Diabetes Risk Score (FINDRISC)-to identify elevated blood glucose levels in seniors.
  
  
  
  A cross-sectional study was conducted in senior living facilities in Edmonton, Alberta, Canada. Those with known diabetes, without capacity, considered frail, or unable to communicate in English were excluded. Participants completed the CANRISK and FINDRISC surveys and had their glycated hemoglobin A1c(HbA1c) measured. Correlations between seniors with elevated risk on the surveys and an HbA1cvalue of 6.5% or higher or 6.0% and higher were assessed.
  
  
  
  In this study, 290 residents participated; their mean age was 84.3 ± 7.3 years, 82 (28%) were men, and their mean HbA1clevel was 5.7% ± 0.4%. Mean CANRISK score was 29.4 ± 8.0, and of the 254 (88%) considered to be moderate or high risk, 10 (4%) had an HbA1clevel of 6.5% or higher and 49 (19%) had an HbA1clevel of 6.0% or higher. Mean FINDRISC score was 10.8 ± 4.2, and of the 58 (20%) considered to be high or very high risk, 4 (7%) had an HbA1clevel of 6.5% or higher and 15 (26%) had an HbA1clevel of 6.0% or higher. The area under the receiver-operating characteristic curve was 0.57 (95% confidence interval 0.42-0.72) for the CANRISK survey identifying participants with an HbA1clevel of 6.5% or higher and 0.59 (95% confidence interval 0.51-0.67) for identifying participants with an HbA1clevel of 6.0% or higher. Similar characteristics were observed for the FINDRISC survey.
  
  
  
  In this group of seniors with no known diabetes history, mean HbA1clevel approximated that in the general population and neither survey effectively identified those with elevated blood glucose levels. These findings should be confirmed in a larger study; nevertheless, routine use of these surveys as a diabetes screening strategy does not appear to be warranted at this time.
authors.affiliation: Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada; Alliance for Canadian Health Outcomes Research in Diabetes, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Travis
authors.initials: T
authors.lastname: Featherstone
authors.affiliation: Alliance for Canadian Health Outcomes Research in Diabetes, University of Alberta, Edmonton, Alberta, Canada; School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Dean T
authors.initials: DT
authors.lastname: Eurich
authors.affiliation: Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada; Alliance for Canadian Health Outcomes Research in Diabetes, University of Alberta, Edmonton, Alberta, Canada. Electronic address: scot@ualberta.ca.
authors.forename: Scot H
authors.initials: SH
authors.lastname: Simpson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta / Q000453:epidemiology; D001786:Blood Glucose / Q000032:analysis; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D012372:ROC Curve; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: population screening; seniors; undetected diabetes