Impact of diabetes on longevity and disability-free life expectancy among older South African adults: a prospective longitudinal analysis
Date
2023-03
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Abstract
Aims—We seek to understand the coexisting effects of population aging and a rising burden of
diabetes on healthy longevity in South Africa.
Methods—We used longitudinal data from the 2015 and 2018 waves of the “Health and Aging
in Africa: A Longitudinal Study of an INDEPTH Community in South Africa” (HAALSI) study
to explore life expectancy (LE) and disability-free life expectancy (DFLE) of adults aged 45 and
older with and without diabetes in rural South Africa. We estimated LE and DFLE by diabetes
status using Markov-based microsimulation.
Results—We find a clear gradient in remaining LE and DFLE based on diabetes status. At age
45, a man without diabetes could expect to live 7.4 [95% CI 3.4 – 11.7] more years than a man
with diabetes, and a woman without diabetes could expect to live 3.9 [95% CI: 0.8 – 6.9] more
years than a woman with diabetes. Individuals with diabetes lived proportionately more years
subject to disability than individuals without diabetes.
Conclusions—We find large and important decrements in disability-free aging for people with
diabetes in South Africa. This finding should motivate efforts to strengthen prevention and
treatment efforts for diabetes and its complications for older adults in this setting.
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Keywords
ADL disability; diabetes mellitus; sub-Saharan Africa; chronic disease