The dynamics of life expectancy over the last six decades in elderly people with diabetes

Aim: To investigate the historical changes in survival with diabetes in elderly people with diabetes. Research design and methods: We analyzed 6504 deaths (44.5% males) registered in a large urban population, aged >65 years, and deceased between 1943 and 2009. We split the analysis into three time periods according to year of death: 1943-1965, 1966-1988 and 1989-2009. The parallel changes in the corresponding general population were available. Results: The mean age at diabetes onset was 70.8 +/- 4.7 years, with mean disease duration at death 7.5 +/- 5 years, and mean age at death 78.3 +/- 5.9 years. The mean survival loss due to diabetes (expected minus observed survival) was 4.5 +/- 5.1 years (4.9 +/- 5.1 years for females versus 4.1 +/- 5.2 years for males, p < 0.001). The mean disease duration at death was 6.4 +/- 5.7 years in the period 1943-1965, followed by a significant (p = 0.019) rise to 7 +/- 5 years in 1966-1988, and 8.3 +/- 4.9 years (p < 0.001) in 1989-2009. There was a significant increase in coronary heart disease and stroke, and a significant decrease in infections and end-stage renal disease as causes of death. Conclusions: We found a significant increase in age at onset and survival with diabetes leading to a significant increase in age at death. Females had a higher survival loss due to diabetes compared with males. (C) 2012 Elsevier Ireland Ltd. All rights reserved.