Social Connections, Diabetes Mellitus, and Risk of Mortality among White and African-American Adults Aged 70 and Older: An Eight-Year Follow-up Study
Introduction
Diabetes mellitus (DM) is the seventh-leading cause of death in the United States. According to the reports by the Centers for Disease Control and Prevention, DM contributed to a total of 233,619 deaths in 2005 in this country 1, 2. Furthermore, the incidence, prevalence, and mortality caused by diabetes and diabetic complications (cardiovascular diseases in particular), increase with aging 2, 3, 4, 5, 6. In addition to mortality risk from diseases, social factors may also have important effects on the risk of mortality 7, 8, 9, 10, 11, 12, 13, 14, 15, 16. Of social factors, social connections, including social communications with family and friends and participation in neighborhood activities, may be especially important during old age when individuals face the greatest risk of illness and disruption in their sources of support 8, 17. However, it is unknown whether a lack of social connections has a significant effect on the risk of death after adjustment for disease and other covariates. Also, the degree to which an excessive risk of death caused by a combined effect of being poor social connections and disease has not been well studied. We hypothesized that both social connections and DM are independent predictors of death and that subjects exposed to both risk factors are at a greater risk of death. To test these hypotheses, we used data from the national Second Longitudinal Study of Aging (LSOA II) (18).
Section snippets
Study Design and Participants
The LSOA II study design and sample selection procedures have been documented and published elsewhere (18). In brief, the LSOA II is a collaborative effort between the National Center for Health Statistics (NCHS) and the National Institute on Aging. The goals of the LSOA II study are to better understand disability pathways and interrelationships between determinants and functional outcomes among older adults. The LSOA II is a longitudinal study with a nationally representative sample
Characteristics of Participants
Table 1 shows that 25.1% of African-American (AA) and 22.1% of white men were aged 80 and older (p < .001). AA men had significantly greater smoking rates than white men (32.9% vs. 20.0%, p<0.001), and they had significantly lower prevalence of coronary heart disease than White males (19.5% vs. 25.5%, p = .024). However, AA men had a significantly greater prevalence of hypertension (48.7% vs. 38.2%, p < .05), and diabetes (21.3% vs. 12.1%, p < .001) than white men.
In women, 26.7% of AA and
Discussion
The present study demonstrates significant associations of having LSC or DM with an increased risk of death among older American adults. Subjects with both LSC and DM had significant combined effects on the risk of death. Furthermore, LSC alone showed to have a similar impact on the survival trends compared with those who had DM only. These associations of LSC and DM with risk of mortality remained significant after adjusting for multiple covariates.
The association between DM and risk of
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2013, American Journal of CardiologyCitation Excerpt :Of the 8 CVD risk factors in the present study, DM, hypertension, and a high cholesterol level had the strongest ORs for the prevalence of CVD. Although these associations have been reported by several studies, including studies of our own work,6,17–21 the findings from the present study suggest that these CVD risk factors appear to be increasing in both race/ethnicity groups, although they have not always attained statistical significance. There is little doubt that without additional aggressive prevention strategies and practices, CVD will not be controlled in the coming decades.
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