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      The impact of a diabetes diagnosis on health and well‐being: Findings from the English Longitudinal Study of Ageing

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          Abstract

          Background

          Poorer health and well‐being are associated with diabetes risk. However, little is known about the trajectory of health and well‐being from before to after diabetes diagnosis. We compared depressive symptoms, quality of life, self‐rated health, and loneliness at three time points (prediagnosis, diagnosis, 2–4 years post diagnosis) in individuals who developed diabetes and a comparison group.

          Methods

          Health and well‐being measures were self‐reported by 3474 participants from the English Longitudinal Study of Ageing. Repeated measures analysis of variance and generalized estimating equations were used to investigate differences by group, time, and group‐by‐time interactions.

          Results

          A total of 473 (13.6%) participants developed diabetes. The diabetes group reported greater depressive symptoms ( W 2 (1) = 20.67, p < .001) and lower quality of life ( F = 1, 2535 = 10.30, p = .001) and were more likely to rate their health as fair/poor ( W 2 (1) = 67.11, p < .001) across time points, adjusting for age, sex, and wealth. They also reported greater loneliness ( F = 1, 2693 = 9.70, p = .002) in unadjusted analyses. However, this was attenuated to the null in adjusted analyses. The group‐by‐time interaction was significant for quality of life ( F = 1.97, 5003.58 = 5.60, p = .004) and self‐rated health ( W 2 (2) = 11.69, p = .003), with a greater decline in these measures over time in the diabetes group in adjusted analyses.

          Conclusion

          People who received a diabetes diagnosis had greater depressive symptoms, lower quality of life, and poorer self‐rated health than those who did not develop diabetes. Quality of life and self‐rated health deteriorated more rapidly following a diagnosis. Screening for these factors around the time of diagnosis could allow for interventions to improve the health and well‐being of those with diabetes.

          Abstract

          Highlights

          • People who develop diabetes report greater depressive symptoms and lower quality of life and rate their health as poorer than those who do not develop diabetes.

          • Around the time of diagnosis, people with diabetes experience a greater decline in quality of life and self‐rated health than adults who do not develop the condition.

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          Most cited references45

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          The MOS 36-ltem Short-Form Health Survey (SF-36)

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            Cohort profile: the English longitudinal study of ageing.

            The English Longitudinal Study of Ageing (ELSA) is a panel study of a representative cohort of men and women living in England aged ≥50 years. It was designed as a sister study to the Health and Retirement Study in the USA and is multidisciplinary in orientation, involving the collection of economic, social, psychological, cognitive, health, biological and genetic data. The study commenced in 2002, and the sample has been followed up every 2 years. Data are collected using computer-assisted personal interviews and self-completion questionnaires, with additional nurse visits for the assessment of biomarkers every 4 years. The original sample consisted of 11 391 members ranging in age from 50 to 100 years. ELSA is harmonized with ageing studies in other countries to facilitate international comparisons, and is linked to financial and health registry data. The data set is openly available to researchers and analysts soon after collection (http://www.esds.ac.uk/longitudinal/access/elsa/l5050.asp).
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              A measure of quality of life in early old age: the theory, development and properties of a needs satisfaction model (CASP-19).

              Quality of life is the subject of much research. However it lacks an agreed theoretical basis. In studies with older populations(ill) health has been used as a proxy measure for quality of life (QoL). We have developed a needs satisfaction measure of QoL in early old age. Our measure has four ontologically grounded domains: conal, autonomy, pleasure, and self-realization. The measure was piloted with focus groups, a self-completion pilot, and cognitive interview testing. This produced a 22-item scale that was included in a postal questionnaire and sent to 286 people aged 65-75 years.A 92% response rate was achieved. The scale was reduced to 19 items on the basis of statistical analysis. The domains have Cronbach's alphas between 0.6 and 0.8. Correlations between the four domains range from 0.4 to 0.7. A second order factor analysis revealed a single latent QoL factor. The scores for the 19-item scale are well distributed along the range although they exhibit a slight negative skew. Concurrent validity was assessed using the Life Satisfaction Index--wellbeing. A strong and positive association was found between the two scales (r= 0.6, p = 0.01). The CASP-19 appears to be a useful scale for measuring QoL in older people.
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                Author and article information

                Contributors
                ruth.hackett@kcl.ac.uk
                Journal
                J Diabetes
                J Diabetes
                10.1111/(ISSN)1753-0407
                JDB
                Journal of Diabetes
                Wiley Publishing Asia Pty Ltd (Melbourne )
                1753-0393
                1753-0407
                19 December 2023
                July 2024
                : 16
                : 7 ( doiID: 10.1111/jdb.v16.7 )
                : e13518
                Affiliations
                [ 1 ] Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
                [ 2 ] Department of Behavioural Science and Health, Institute of Epidemiology and Health Care University College London London UK
                Author notes
                [*] [* ] Correspondence

                Ruth A. Hackett, Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

                Email: ruth.hackett@ 123456kcl.ac.uk

                Author information
                https://orcid.org/0000-0002-5428-2950
                Article
                JDB13518
                10.1111/1753-0407.13518
                11212344
                38112231
                cca45677-052e-492a-8645-e6609e48be16
                © 2023 The Author(s). Journal of Diabetes published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 27 October 2023
                : 30 June 2023
                : 23 November 2023
                Page count
                Figures: 4, Tables: 2, Pages: 11, Words: 7317
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                July 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.4.5 mode:remove_FC converted:28.06.2024

                Endocrinology & Diabetes
                diabetes,diagnosis,health,quality of life,well‐being
                Endocrinology & Diabetes
                diabetes, diagnosis, health, quality of life, well‐being

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