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Older adults with dementia less likely to have diabetes mellitus monitored

A recent study found that older patients with diabetes mellitus and comorbid dementia often do not receive the recommended annual monitoring for diabetes mellitus.

In a retrospective cohort study, researchers identified a sample of 288,805 patients with diabetes mellitus (DM) from the 2005-2006 Chronic Conditions Warehouse as part of the CMS. Eligible patients received Medicare fee-for-service beneficiaries and were aged 65 years or older.

Researchers also assessed whether each patient had undergone at least one glycosylated hemoglobin test (HbA1c), one low-density lipoprotein test (LDL-C), and one annual eye examination. Dementia was then identified in 15.5% of patients (n=44,717).

Analyses showed that 79.7% of the patients had one or more HbA1c tests, 76.2% had one or more LDL-C tests, and 61.6% had an annual eye examination; 44.7% received all three tests.

The unadjusted differences in the rates of DM patients with dementia who received diabetes monitoring tests compared with patients without dementia were significantly lower for HbA1c (73.3% vs. 80.8%), LDL-C (60.6% vs. 79.1%), eye exams (52.2% vs. 63.3%), and all three tests (30.4% vs. 47.4%; all P<.001). The adjusted predicted probability of DM patients with dementia receiving all three tests was 36.9% compared with 46.2% for participants without dementia (ARR=0.80; 95% CI, 0.787-0.0811). Participants with dementia were least likely to undergo eye examinations.

“Dementia reduces the likelihood that individuals with DM will receive recommended annual monitoring for DM,” researchers wrote. “More research is needed to understand reasons for lower monitoring in this subgroup.”