Objective: T2DM effects approximately 25% of older adults and prevalence of cognitive decline (CD) increases with age. Furthermore, some research suggests that individuals living with these conditions find it difficult to manage their health. The goal of this study was to use the 2015 BRFSS to assess the difference in disease burden experienced by older adults with T2DM and with or without CD.

Research Design and Methods: Older adults with T2DM were assessed for CD based on self-reported affirmative responses to the Cognitive Decline questions. Disease burden was assessed using Healthy Days—Health Related Quality of Life questions. Logistic regression was used to determine the likelihood of disease burden based on cognitive status. Differences in reported days of disease burden between those with and without CD using pairwise comparison of marginal linear predictions. An alpha level of .05 was used.

Results: The sample reported an average of 3 chronic conditions in addition to T2DM. Compared to those without CD, those with CD had a 57% increased likelihood of experiencing poor physical health, were 2.7x as likely to report poor mental health, and had a 97% increased likelihood of reporting poor physical or mental health impeded usual activities, including self-care. There was also a significant difference in the number of days of disease burden reported by those with cognitive decline for poor physical (+6.1 days) and mental health (+5.2 days) and the number of days that poor physical or mental health interfered with usual activities (+4.8 days).

Conclusion: As the population ages, it is imperative to understand how CD influences disease burden and ability to perform T2DM-related self-care activities. Future research is needed to understand, along with cognitive decline, how geriatric syndromes and other chronic conditions contribute to disease burden in older adults. Also, additional research is needed to identify potential social determinants that may be unique to older adults with T2DM.


B.L. Smalls: None. S.H. Bardach: None. N. Schoenberg: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.