Self-reported diabetic complications and 7-year mortality in Mexican American elders - Findings from a community-based study of five Southwestern states

Purpose: This study was designed to examine the relationship between self-reported diabetic complications and 7-year mortality in Mexican American elders. Methods: We studied 3050 Mexican Americans aged 65 and older from the Hispanic Established Population for the Epidemiological Studies of the Elderly (EPESE), conducted in five Southwestern states of the United States, for whom data were available from the baseline interview in 1993-1994 and three follow-up interviews in 1995-1996, 1998-1999, and 2000-2001. A total of 690 respondents in the baseline interview reported a physician's diagnosis of diabetes. Results: Of 690 patients with diabetes, 412 (59.7%) subjects had self-reported complications of eye, kidney, circulation problems, or amputations, and 276 (40%) died within the 7-year follow-up. Compared to patients without any diabetic complications, subjects with only one complication were not statistically significantly different in terms of the 7-year mortality (hazard ratio with 95% CI: 1.30, 0.96-1.76), after adjusting for age, sex, living arrangements, smoking, drinking, past medical history of stroke, heart attack, hypertension, cancer, and hip fracture. However, those with two or three complications were nearly twice as likely to die within 7 years than those without complications (1.75, 1.26-2.43 and 1.80, 1.17-2.79, respectively), whereas patients with four complications were nearly three times more likely to die (2.86, 1.47-5.58). Conclusion: The risk of 7-year mortality increased with the number of diabetic complications among Mexican American older adults. Detection of and early treatment/ control for diabetic complications may lead-to increase survival in this population. (C) 2003 Elsevier Inc. All rights reserved.