5-YEAR MORTALITY IN ELDERLY FRENCH SUBJECTS FROM THE PAQUID EPIDEMIOLOGIC SURVEY - THE BURDEN OF DIABETES

We describe the 5-year mortality and its risk factors in a cohort of e lderly people with and without known diabetes mellitus. The PAQUID coh ort was representative of the population older than 65 living in Giron de, south-west France. Potential mortality risk factors were collected during a baseline evaluation, using, a health questionnaire, from 68. 9 % of a randomly selected sample of over-65s in 1988. A total of 237 subjects (8.5 %) had diabetes. Annual review occurred for 5 years and cause of any death was ascertained from family doctors. After 5 years, 623 people (22.3 %) had died, of whom 576 were non-demented; 30.0 % o f the diabetic group versus 20.3 % of the non-diabetic group had died. Survival of the known diabetic group was lower than that of the non-d iabetic group (p < 0.001), although this excess mortality was signific ant only in the 65 to 75 age range (relative risk 1.8; 95 % confidence interval 1.2 to 2.8, p = 0.04). Cardiovascular mortality rate did not differ between the diabetic and non-diabetic groups (RR 1.2 [0.8-2.0] ). Death related to neoplasia was significantly higher in the known di abetic group (RR 2.2 [1.2-3.3], p = 0.01). In the final model, integra ting diabetes as a mortality risk factor in the total cohort, known di abetes at the baseline examination was an independent risk factor for mortality (RR 1.4 [1.0-1.8], p = 0.01), in addition to tobacco use, hy pertension and functional dependency. These results confirm suggestion s that diabetes increases mortality in the over-65 age group, perhaps with an adverse interaction with other pathology. (C) 1998 John Wiley & Sons, Ltd.