Endocrinology Section, Northeast Ohio Veterans Healthcare System, Cleveland, OH, USA.
Department of Medicine, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Expert Rev Endocrinol Metab. 2020 Mar;15(2):71-81. doi: 10.1080/17446651.2020.1737520. Epub 2020 Mar 16.
: As the population ages, the number of older adults with diabetes mellitus will continue to rise. The burden of diabetes on older adults is significant due to the disease itself, its complications, and its treatments. This is compounded by geriatric syndromes such as frailty and cognitive dysfunction. Consequently, health and diabetes-related quality of life (QoL) are diminished.: This article reviews the value of assessing QoL in providing patient-centered care and the associations between QoL measures and health outcomes. The determinants of QoL particular to diabetes and the older population are reviewed, including psychosocial, physical, and cognitive burdens of diabetes and aging and the impact of hypoglycemia on QoL. Strategies are described to alleviate these burdens and improve QoL, and barriers to multidisciplinary patient-centered care are discussed. QoL measurement instruments are reviewed.: The goals of treating diabetes and its complications should be considered carefully along with each patient's capacity to withstand the burdens of treatment. This capacity is reduced by socioeconomic, psychological, cognitive, and physical factors reduces this capacity. Incorporating measurement of HRQoL into clinical practices is possible, but deficiencies in the systems of health-care delivery need to be addressed to facilitate their use.
随着人口老龄化,糖尿病患者的数量将继续增加。由于疾病本身、其并发症和治疗方法,糖尿病给老年人带来了沉重的负担。这因衰弱和认知功能障碍等老年综合征而更加复杂。因此,健康和与糖尿病相关的生活质量(QoL)受到了影响。本文综述了评估 QoL 在提供以患者为中心的护理中的价值,以及 QoL 测量与健康结果之间的关联。回顾了糖尿病和老年人群中与 QoL 相关的特定决定因素,包括糖尿病和衰老的心理社会、身体和认知负担以及低血糖对 QoL 的影响。描述了减轻这些负担和改善 QoL 的策略,并讨论了多学科以患者为中心的护理的障碍。本文还回顾了 QoL 测量工具。治疗糖尿病及其并发症的目标应与每位患者承受治疗负担的能力一起仔细考虑。社会经济、心理、认知和身体因素会降低这种能力,从而降低了这种能力。将 HRQoL 测量纳入临床实践是可行的,但需要解决医疗保健提供系统中的缺陷,以促进其使用。