Prevalence and Predictors of Co-Occurring Diabetes and Hypertension in Community-Dwelling Older Adults

Background and Purpose: The prevalence of co-occurring diabetes and hypertension among older adults has not been well-established, and predictors of co-occurring diabetes and hypertension have been largely unexamined. This is an important public health and clinical consideration given the adverse effects of co-occurring diabetes and hypertension on the survival and well-being of older adults. To fill this knowledge gap, using a sample of community-dwelling older adults living in the state of Alabama, this study estimated the prevalence of co-occurring diabetes and hypertension among older adults, examined predictors of co-occurring diabetes and hypertension, and ascertained whether predictors varied by race.

Methods: A retrospective analysis was conducted using a statewide survey of Alabama community-dwelling older adults (n=1,204). Measures of central tendency and frequency distributions were used for univariate analysis. Binomial logistic regression was used to predict co-occurring diabetes and hypertension.

Results: The prevalence of co-occurring diabetes and hypertension among older adults was 17%. African American race (OR=2.28, CI: 1.596-3.255), BMI≥30 (OR=2.45, CI=1.732-3.463), heart disease (OR=1.93, CI: 1.355-2.756), and eye disease (OR=1.44, CI: 1.018-2.024) were associated positively with co-occurring diabetes and hypertension. Lower levels of self-perceived health (OR=.501, CI=.957-1.40) were negatively associated with co-occurring diabetes and hypertension. Stratified by race, obesity was positively associated with co-occurring diabetes and hypertension for whites (OR=3.05, CI=1.95-4.77) and eye disease for African Americans (OR=1.72, CI=1.01-2.95); and heart disease was positively associated for both African Americans and whites (OR=1.95, CI=1.11-3.42; OR=2.00, CI=1.26-3.17) and lower levels of self-perceived health were negatively associated for both racial groups (OR=0.50, CI=0.36-0.70; OR=0.50, 0.39-0.64).

Conclusions and Implications: The prevalence of co-occurring diabetes and hypertension among older adults was alarmingly high. The notable difference in the likelihood of co-occurring diabetes and hypertension is representative of a racial health disparity that largely disfavors African American older adults. Findings from this study highlight a need for identification of older adults who have and who are at risk of co-occurring diabetes and hypertension in the general population and in clinical settings, and development and implementation of suitable interventions, particularly targeted for older African American older adults.