Diabetes and Cardiovascular Disease in Older Adults: Current Status and Future Directions

  1. Kevin P. High13
  1. 1Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Ann Arbor, MI
  2. 2Geriatric Research, Education and Clinical Center, University of Texas Health Sciences Center at San Antonio and South Texas Veterans Health Care System, San Antonio, TX
  3. 3Association of Specialty Professors, Alexandria, VA
  4. 4Department of Medicine, Division of Endocrinology, Albert Einstein College of Medicine, Bronx, NY
  5. 5University of Maryland School of Medicine and Baltimore VA Medical Center Geriatric Research Education and Clinical Center, Baltimore, MD
  6. 6Western University of Health Sciences, Pomona, CA
  7. 7Department of Medicine, University of Washington, Puget Sound VA Health Care System, Seattle, WA
  8. 8Department of Medicine, Division of General Internal Medicine, University of Chicago, Chicago, IL
  9. 9Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina, Chapel Hill, NC
  10. 10Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, MA
  11. 11Geriatric Research, Education and Clinical Center, Duke University School of Medicine and Durham VA Medical Center, Durham, NC
  12. 12National Institute on Aging, Bethesda, MD
  13. 13Department of Internal Medicine, Section on Infectious Diseases, Wake Forest School of Medicine, Winston-Salem, NC
  1. Corresponding authors: Jeffrey B. Halter, jhalter{at}umich.edu, and Nicolas Musi, musi{at}uthscsa.edu.

Abstract

The prevalence of diabetes increases with age, driven in part by an absolute increase in incidence among adults aged 65 years and older. Individuals with diabetes are at higher risk for cardiovascular disease, and age strongly predicts cardiovascular complications. Inflammation and oxidative stress appear to play some role in the mechanisms underlying aging, diabetes, cardiovascular disease, and other complications of diabetes. However, the mechanisms underlying the age-associated increase in risk for diabetes and diabetes-related cardiovascular disease remain poorly understood. Moreover, because of the heterogeneity of the older population, a lack of understanding of the biology of aging, and inadequate study of the effects of treatments on traditional complications and geriatric conditions associated with diabetes, no consensus exists on the optimal interventions for older diabetic adults. The Association of Specialty Professors, along with the National Institute on Aging, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Heart, Lung, and Blood Institute, and the American Diabetes Association, held a workshop, summarized in this Perspective, to discuss current knowledge regarding diabetes and cardiovascular disease in older adults, identify gaps, and propose questions to guide future research.

  • Received January 6, 2014.
  • Accepted April 10, 2014.
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