Journals of Gerontology Series A: Biological Sciences and Medical Sciences Large Type Edition
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The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 59:M640-M645 (2004)
© 2004 The Gerontological Society of America

Diabetes Mellitus as a Risk Factor for Stroke Incidence and Mortality in Mexican American Older Adults

Kenneth J. Ottenbacher1,2,4,, Glenn V. Ostir2,3, M. Kristen Peek2,4 and Kyriakos S. Markides2,4

1 Division of Rehabilitation Sciences, University of Texas Medical Branch at Galveston.
2 Sealy Center on Aging, University of Texas Medical Branch at Galveston.
3 Division of Geriatrics, Department of Medicine, University of Texas Medical Branch at Galveston.
4 Department of Preventive Medicine and Community Health, University of Texas Medical Branch at Galveston.

Address correspondence to Kenneth J. Ottenbacher, UTMB, 301 University Blvd., Galveston, TX 77555-1137. E-mail: kottenba{at}utmb.edu

Background. Little is known regarding diabetes mellitus as a risk factor for stroke incidence and death in older Mexican Americans. The authors studied diabetes and other potential risk factors for stroke in a sample of community-dwelling older Mexican Americans.

Methods. A prospective cohort design was used that involved the Hispanic Established Population for the Epidemiologic Study of the Elderly, a longitudinal study using a weighted probability sample of Mexican Americans (aged older than 65 years) living in the southwestern United States. 3050 older Mexican American persons were originally interviewed and tested at baseline and then followed with reassessment at 2, 5, and 7 years. The incidence of stroke and stroke death were studied for the participants during a 7-year follow-up period.

Results. 690 participants were identified at baseline with diabetes. 238 participants experienced a first-time stroke during the follow-up period. 66 died as a result of a stroke. Cox proportional hazard regression analysis revealed an increased hazard ratio (HR) for stroke in persons with diabetes (HR, 1.80; 95% confidence interval [CI], 1.32 to 2.44; p <.0002) when adjusted for age, sex, body mass index, smoking, systolic blood pressure, previous heart attack, and lower extremity function. The stroke mortality rate was also higher (HR, 2.02; 95% CI, 1.04 to 3.93) for persons with diabetes when adjusted for covariates.

Conclusion. Diabetes was associated with an increased incidence of stroke and death in older Mexican Americans, particularly those taking insulin.






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