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Research Article| Volume 197, 110577, March 2023

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Impact of diabetes on longevity and disability-free life expectancy among older South African adults: A prospective longitudinal analysis

  • Collin F. Payne
    Affiliations
    School of Demography, Research School of Social Sciences, The Australian National University, Canberra, Australia

    Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, USA
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  • Lilipramawanty K. Liwin
    Affiliations
    School of Demography, Research School of Social Sciences, The Australian National University, Canberra, Australia
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  • Alisha N. Wade
    Affiliations
    MRC/Wits Rural Public Health and Heath Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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  • Brian Houle
    Affiliations
    School of Demography, Research School of Social Sciences, The Australian National University, Canberra, Australia

    MRC/Wits Rural Public Health and Heath Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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  • Jacques D. Du Toit
    Affiliations
    MRC/Wits Rural Public Health and Heath Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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  • Author Footnotes
    1 Denotes joint senior authors.
    David Flood
    Correspondence
    Corresponding author at: F4315 University Hospital South, Unit 4, Ann Arbor, MI 48109, USA.
    Footnotes
    1 Denotes joint senior authors.
    Affiliations
    Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA

    Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, USA

    Center for Indigenous Health Research, Maya Health Alliance, Tecpán, Guatemala
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  • Author Footnotes
    1 Denotes joint senior authors.
    Jennifer Manne-Goehler
    Footnotes
    1 Denotes joint senior authors.
    Affiliations
    Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, USA

    Division of Infectious Diseases, Massachusetts General Hospital, Boston, USA
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  • Author Footnotes
    1 Denotes joint senior authors.
Published:February 11, 2023DOI:https://doi.org/10.1016/j.diabres.2023.110577

      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.

      Keywords

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