PREVALENCE OF DIABETES AND EFFECT ON QUALITY-OF-LIFE IN OLDER FRENCH LIVING IN THE COMMUNITY - THE PAQUID EPIDEMIOLOGIC SURVEY

OBJECTIVES: To evaluate the prevalence of diabetes mellitus in older F rench subjects and to examine the different aspects of quality of life in an older diabetic population. DESIGN: From a random sample of 2792 people older than age 65 living in the community, a diabetic sample w as selected using three items from a questionnaire: Are you diabetic! Are you on a diabetic diet? What kind of medications do you take daily ? Validation of the questionnaire was carried out previously to correc t the observed prevalence. MEASUREMENTS: The questionnaire assessed so cial and demographic aspects, physical, mental, and subjective health, and functional disabilities. Because quality of life assessment was m ainly subjective, demented subjects were excluded. RESULTS: The diabet ic group consisted of 237 subjects from the older sample of 2792 (8.5% ). No age difference was demonstrated between the two groups (mean, di stribution), but the male/female ratio was significantly higher in tho se with diabetes (49.4% vs 39.3%, P = .003). Corrected prevalence of d iabetes was 10.3%. After exclusion of demented subjects, 230/2726 peop le were investigated. Diabetic subjects were heavier (P < .001), had h igher systolic blood pressure (P < .001), and had more frequent sympto ms of ischemic heart disease (P < .001) and painful peripheral arteria l disease (P < .001) and dyspnea (P < .001), but antecedents of stroke were similar in both groups. Diabetics were more often lacking in aut onomy according to the IADL Lawton scale (P < .001), Rosow and Breslow scale (P < .001), and Mobility scale (P=.043), but not according to t he Katz ADL scale. They more often exhibited symptoms of depression on the CES-D self-rating scale (21.3% vs 12.7%, P < .001), but evaluatio n of cognitive function was similar in; both groups. Thirteen percent of diabetics, compared with 7.6% of nondiabetics, were unsatisfied wit h their own situation (P = .002). Health was rated as fair, bad, or ve ry bad by 67.8% of diabetics compared with 49% of non-diabetics (P < . 001). Diabetics rated themselves as feeling worse than others (15.3% v s 9.2%, P << .001) and worried more about their health status (78% vs 63%, P << .001). CONCLUSION: The observed prevalence of diabetes in ol der French people living in the community was 8.5%. Quality of life in older diabetics was poorer than that of other people of the same age.