Classification of Older Adults Who Have Diabetes by Comorbid Conditions, United States, 2005-2006
Classification of Older Adults Who Have Diabetes by Comorbid Conditions, United States, 2005-2006
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DOI：
10.5888/pcd9.110287
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发表时间：
2012-05-01
影响因子：
5.5
通讯作者：
Huang, Elbert S.
中科院分区：
文献类型：
--
作者：
Laiteerapong, Neda;Iveniuk, James;Huang, Elbert S.
老年糖尿病患者在合并症方面差异很大；这些情况有助于确定强化血糖控制的风险和益处。并不是所有人都能从强化血糖控制中获益。本研究的目的是根据合并症对患有糖尿病的美国老年人进行分类，以确定那些不太可能从强化血糖控制中获益的人。方法我们使用潜在分类分析来确定具有全国代表性的社区居住的老年糖尿病患者（57-85岁）的亚组（n = 750）。亚组根据老年人群中普遍存在的14种合并症进行分类。采用赤池信息准则、贝叶斯信息准则（BIC）、调整样本容量的BIC、拟合优度统计，我们评估模型的拟合。结果我们发现了3个不同的亚群。类1（占样本的63%）在大多数情况下的概率最低。第2类（占样本的29%）患癌症、尿失禁和肾脏疾病的概率最高。第3类（占样本的9%）发生充血性心力衰竭和心肌梗死的概率最高（>90%）。第1类只有0、1或2种共病，第2类和第3类都有6种或更多共病。2类（17%）和3类（33%）的5年死亡率高于1类（9%）。结论：患有糖尿病、心血管疾病和6种或6种以上合并症的老年人可能是不太可能从强化血糖控制中获益的老年人亚组。
IntroductionOlder adults who have diabetes vary widely in terms of comorbid conditions; these conditions help determine the risks and benefits of intensive glycemic control. Not all people benefit from intensive glycemic control. The objective of this study was to classify by comorbid conditions older American adults who have diabetes to identify those who are less likely to benefit from intensive glycemic control.MethodsWe used latent class analysis to identify subgroups of a nationally representative sample of community-dwelling older adults (aged 57-85 y) who have diabetes (n = 750). The subgroups were classified according to 14 comorbid conditions prevalent in the older population. Using the Akaike Information Criterion, the Bayesian Information Criterion (BIC), the sample-size adjusted BIC, and the; goodness-of-fit statistic, we assessed model fit.ResultsWe found 3 distinct subgroups. Class 1 (63% of the sample) had the lowest probabilities for most conditions. Class 2 (29% of the sample) had the highest probabilities of cancer, incontinence, and kidney disease. Class 3 (9% of the sample) had the highest probabilities (>90%) of congestive heart failure and myocardial infarction. Class 1 had only 0, 1, or 2 comorbid conditions, and both class 2 and class 3 had 6 or more comorbid conditions. The 5-year death rates for class 2 (17%) and class 3 (33%) were higher than the rate for class 1 (9%).ConclusionOlder adults who have diabetes, cardiovascular disease, and 6 or more comorbid conditions may represent a subgroup of older adults who are less likely to benefit from intensive glycemic control.