Diabetes Care

ObjectiveQuantify the impact of diabetes status on healthy and disabled years of life for older adults in the U.S. and provide a baseline from which to evaluate ongoing national public health efforts to prevent and control diabetes and disability.Research Design and Methods20,008 adults aged 50 years and older followed from 1998 to 2012 in the Health and Retirement Study, a prospective biannual survey of a nationally representative sample adults. Diabetes and disability status (defined by mobility loss, difficulty with instrumental activities [IADL], and/or difficulty with activities of daily living [ADL]) were self-reported. We estimated incidence of disability, remission to non-disability, and mortality. We developed a discrete-time Markov simulation model with a 1-year transition cycle to predict and compare lifetime disability-related outcomes between persons with and without diabetes. Data represent the U.S. population in 1998.ResultsFrom age 50, diabetic adults died 4.6 years earlier, developed disability six to seven years earlier and spent about one to two more years in a disabled state than non-diabetic adults. With increasing baseline age, diabetes was associated with significant (p