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Age and Ageing Advance Access published online on May 5, 2006
Age and Ageing, doi:10.1093/ageing/afl019
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© The Author 2006. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received September 6, 2005
Accepted March 7, 2006

Review

Mortality in people diagnosed with type 2 diabetes at an older age: a systematic review

Karen N. Barnett 1 *, Marion E. T. Mcmurdo 2, Simon A. Ogston 1, Andrew D. Morris 3, and Josie M. M. Evans 1

1 Section of Public Health, Division of Community Health Sciences, University of Dundee, The Mackenzie Building, Kirsty Semple Way, Dundee DD2 4BF, UK
2 Division of Medicine and Therapeutics, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK
3 School of Medicine, University of Dundee, Ninewells Hospital, Dundee DD1 9SY, UK

* To whom correspondence should be addressed.
Karen N. Barnett, E-mail: k.barnett{at}chs.dundee.ac.uk


  Abstract

Objectives: To review all published observational studies reporting on all-cause mortality in patients with type 2 diabetes to determine the degree of increased mortality when diagnosed at an older age.

Design: Systematic literature search.

Setting: The review included studies carried out in populations from Germany, United Kingdom, United States, Japan, Italy, Western Australia, Netherlands and Sweden.

Measurements: Medline, CINAHL, EMBASE, National Research Register and Cochrane Reviews were systematically searched from 1975 to 2004. We identified observational studies that reported overall mortality for people diagnosed with type 2 diabetes when they were over the age of 60, compared with a non-diabetic population. Outcome measures were expressed as risk ratios or relative risks.

Results: Among 14 eligible studies, one study reported reduced mortality for patients diagnosed with type 2 diabetes over the age of 60, whereas another found virtually no increased risk of mortality. However, 7 of the 14 studies reported increased mortality in all patients diagnosed when older, and 5 studies for certain subgroups only. A meta-analysis showed the combined relative risks (with 95% CI) of increased mortality for men diagnosed between the ages of 60 and 70 to be 1.38 (1.08-1.76) and 1.13 (0.88-1.45) for men diagnosed aged 70 years or older. A similar pattern was found for the same age groups for women, with combined relative risks of 1.40 (1.10-1.79) and 1.19 (0.93-1.52) respectively.

Conclusion: Increased mortality associated with a diagnosis of type 2 diabetes at an older age is lower than that reported for the general older diabetic population.

Keywords: type 2 diabetes, mortality, older people.
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