Aims: Incidence and prevalence of diabetes increases with age, but impact of diabetes at advanced older age is not well characterised. We investigated the association of diabetes with perceived limitations, wellbeing and health expectations in oldest old men.
Methods: Cross-sectional analysis community-dwelling men aged 79-97 years from Perth, Western Australia. Limitations on daily activities, emotional health and health expectations were assessed by questionnaire. Proportions of men with or without diabetes who reported these issues were compared using the Chi Square test.
Results: Of 1,426 men, 315 had diabetes (22%). Men with diabetes were of comparable age to men without (84.9 vs 84.5 years, p=0.14). Average HbA1c in men with diabetes was 6.6±0.8% (49±8 mmol/mol) and 90.6% of these men were on diet or oral glucose-lowering therapy. Compared to non-diabetic men, more men with diabetes reported that their health limited performance of moderate physical activities (61.1 vs 49.4%, p<0.001), carrying groceries (47.3 vs 35.7%, p<0.001), walking 100 m (34.6 vs 24.6%, p<0.001) and bathing or dressing (21.3 vs 15.2%, p<0.001). Men with diabetes were more likely to have accomplished less than they would have liked in the past 4 weeks due to their physical health (66.0 vs 54.8%, p<0.001). More men with diabetes reported less interest or pleasure in doing things (33.3 vs 22.6%, p<0.001) and felt worn out (18.2 vs 10.6%, p<0.001). Fewer men with diabetes felt as healthy as their peers (67.0 vs 74.1%, p=0.012) and more expected health to worsen (41.1 vs 34.3%, p=0.028).
Conclusions: In men aged 79-97 years, diabetes is associated with greater limitations on daily activities, lower levels of wellbeing and diminished health expectations despite relatively good glycemic control. Interventions to encourage and facilitate daily activities should be investigated in older adults with diabetes to determine whether these would improve mental health.