SPHC Myanmar - Research paper: ASCVD Risk Factors in Older Adult with Diabetes

ASCVD Risk Factors in Older Adult with Diabetes

Background

• It is estimated that in 2017 there were 451 million (age 18– 99years) people with diabetes worldwide, and these figures are expected to increase to 693 million by 2045.
• A major shift in the epidemiology of diabetes has been to those aged 60–79 years.
• Apart from this advancing tide of older people with diabetes, the ageing process itself is increasing the number ofpeople living with the sequelae of ill health, chronic diseases, frailty and injuries, all of which enhance disability and functional decline, and pose real clinical challenges and burdens in those with Type 2 diabetes.
• Diabetes is highly prevalent in the aging population, affecting >25% of individuals aged >65 years and 19% of those aged >75 years. Physiological changes associated with aging increase susceptibility to coronary heart disease and other atherosclerotic cardiovascular disease (ASCVD) processes. The incidence and prevalence of ASCVD-related macrovascular events essentially doubles in older adults with diabetes.
• The overlap of older age, diabetes, and other ASCVD risk factors enhances risk for microvascular and macrovascular complications, functional disability, and geriatric syndromes (including frailty, multimorbidity, polypharmacy, cognitive impairment, depression, urinary incontinence, and falls). As the population of older adults grows, the implications of diabetes on ASCVD risk escalate, and insights regarding optimal care become increasingly important.