‘Expansion of Morbidity’ or ‘Dynamic Equilibrium’ in the Case of Diabetes? Changes of Disability Rates between 2004 and 2015 in Germany and the Role of Co-Morbidity

Stefanie Sperlich , Hannover Medical School
Johannes Beller, Hannover Medical School
Juliane Tetzlaff, Hannover Medical School
Jelena Epping, Hannover Medical School
Siegfried Geyer, Hannover Medical School

Background: Previous studies have shown that individuals with diabetes may encounter increased disability risks. However, studies investigating changes of disabilities and functional impairments over time are scarce. The purpose of this study was to investigate changes of disability rates among older adults with diabetes and to analyze the contribution of co-morbidities (obesity, depression and multi-morbidity). Methods: German Data were derived from the Survey of Health, Ageing, and Retirement in Europe (SHARE). We estimated predicted probabilities of self-reported disabilities (ADL / IADL) by means of logistic regression. Multivariate decomposition for nonlinear response models was employed for analyzing the impact of co-morbidity on changes in disability rates among individuals with diabetes between 2004/5 (wave 1) and 2015 (wave 6). Results: Among older adults with diabetes predicted probabilities of ADL rose from 10.2% in wave 1 to 16.8% in wave 6. With respect to IADL, probabilities increased among men while minor decreases emerged in women. Decomposition analysis revealed that the parallel increase of multi-morbidity and obesity rates contributed to the rise in disabilities among older adults with diabetes, while depression was less important. Discussion: In addition to diabetes prevalence also the rates of severe functional limitations among individuals with diabetes increased over time. As our findings lend support to the hypothesis of expansion of morbidity for the case of diabetes, the German health care system may be facing higher demands in the future. Our findings suggest that this may be fueled by parallel increases of co-morbidity and obesity among individuals with diabetes.

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 Presented in Session 82. Healthy Life Expectancies II