Profile and disparities in health outcomes for older adults with dual diagnoses of diabetes and Alzheimer's disease

BackgroundDiagnosis of either diabetes or Alzheimer's disease presents substantial health challenges for older adults; however, the presence of both conditions concurrently significantly exacerbates these difficulties, complicating medical management and elevating the risk of adverse health outcomes.ObjectiveGuided by syndemic theory and quantitative analyses, we examined the health profiles of older adults with dual diagnoses using national-level longitudinal data.MethodsWe utilized the Uniform Data Set (UDS) from the Alzheimer's Disease Research Centers (ADRCs) which contains demographics, neurological examination findings, and diagnoses for older adults. We analyzed 192,240 participant-visit records from 52,537 UDS participants in a pooled cross-sectional design. We conducted statistical analyses to examine disparities in health between those with dual diagnoses and those with a single diagnosis.ResultsWe found significant associations between dual diagnoses and worsened outcomes across multiple domains, including systolic blood pressure, and utilization of medications, along with higher odds of anxiety and schizophrenia, compared to those with either condition alone or neither condition. For those with Alzheimer's disease only, we find higher levels diastolic blood pressure and higher odds of speech apraxia and depression compared to the other groups. The diabetes only group has higher levels of body mass index and higher odds of hypertension and sleep disorders. These findings underscore the heightened burden of comorbidity in this population.ConclusionsFindings emphasize compounded challenges faced by older adults with dual diagnoses of diabetes and Alzheimer's disease-challenges that are not merely additive but synergistic in nature. The co-occurrence of epidemics among adults in the U.S. highlights the urgent need for policies that address their specific needs.