1077-P: Assessing the Relationship among Multimorbidity, Psychosocial Factors, and Clinical Outcomes in Older Adults Living in Rural Appalachia

Abstract

Type 2 diabetes (T2DM) is a significant public health burden in rural Appalachian Kentucky, with an estimated one in four older adults diagnosed with T2DM. To determine factors associated with T2DM, we assessed the relationship between multimorbidity (MM) , psychosocial factors, and clinical outcomes among 148 older adults with T2DM along with one or more comorbid conditions, living in rural Appalachian Kentucky. A community-based sample of Appalachian residents provided data on diabetes knowledge, chronic conditions in addition to T2DM, demographics, and clinical measures (HbA1c, blood pressure) using point-of-care methods.The sample population (N=148) had an average age of 72.2 years (± 5.4) and were mostly women (66%) and White (98%) , reflecting the region’s demographics. The average HbA1c was 7.6 (±1.3) and systolic and diastolic blood pressure were 145.2 (±20.8) mmHg and 81.9 (±12.6) mmHg, respectively. Participants reported having 2.3 (±1) chronic conditions in addition to T2DM. As for psychosocial factors, participants reported average score stress 20.7 (±9.1) , distress 26.7 (±10.7) , and social support 115.0 (±15.9) . There was a significant relationship between MM and HbA1c (β=0.27, SE=0.13, p=0.04) and stress (β=0.23, SE=0.08, p=0.004) . However, distress, social support, disability, and depression did not have significant relationships with MM in this sample.These findings elucidate the burden of MM in older adults who are living with T2DM in a rural environment. Though MM is not unique to the aging population, understanding how MM effects clinical outcomes and T2DM related psychosocial factors is important. In most cases, properly managing T2DM could reduce (or prevent) severity and complications of comorbid conditions. Thus, identifying psychosocial factors that are associated with clinical outcomes provides a pathway for targeted interventions to improve health outcomes for this vulnerable population. Disclosure B.L.Smalls: None. A.Adegboyega: None. P.Simon-okube: None. P.Westgate: None. N.Schoenberg: n/a. Funding NIDDK RDK112136NIDDK K01DK116923