Background: In China, the prevalence of diabetes is increasing and the prevalence of disability in the elderly population is decreasing. However, few studies have analyzed the change of ADL or IADL disability and the influence of comorbidity in elderly patients with diabetes in China using national data.
Methods: Based on data from Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018, this study not only explored the trend of Chinese elderly prevalence of diabetes and disability but using multivariate decomposition method analyzed the influence of comorbidity in patient’s disability with diabetes between 2008 and 2018.
Results: The prevalence of diabetes among the elderly in China increased from 4.2 percent in 2008 to 13.5 percent in 2018, with a larger increase among women, and the prevalence of diabetes in the elderly was lower than that in the younger age group. For older adults with diabetes, the estimated likelihood of ADL having at least one difficulty decreased from 8.3 percent in 2008 to 6.3 percent in 2018. The proportion of women with diabetes with at least one difficulty in IADL increased and decreased in men. The decrease of underweight contributed the most to the decrease of ADL and IADL in men, accounting for 52.8% and 61.4%, respectively. The decrease in the proportion of somatic comorbidities, underweight, and negative emotions was associated with a decrease in the likelihood of having at least one difficulty in ADL in women with diabetes (14.8%, 23.8%, and 30.3%, respectively). Comorbidities had no significant effect on the increased probability of women having at least one difficulty with IADL.
Conclusions: Although the prevalence of diabetes in older Chinese adults increased over time, the proportion of male and female adults with at least one difficulty in IADL decreased over time, except for a slight increase in the proportion of female adults in IADL. The proportion of underweight and negative emotion in diabetic patients showed a decreasing trend, which to a certain extent inhibited the negative impact of the increase in the prevalence of somatic comorbidities and elderly disability. The results of this study partially support the "dynamic equilibrium" hypothesis of diabetes incidence. Keywords: Comorbidities in diabetic, Disability, Multivariate decomposition method, Dynamic equilibrium