Development of elderly diabetes burden scale for elderly patients with diabetes mellitus

Abstract

Background: The purpose of the present paper was to validate an elderly diabetes burden scale (EDBS) and to assess its correlates in elderly patients with diabetes mellitus.Methods: Comprehensive questionnaires about both diabetes‐specific and non‐specific quality of life (QOL) were given by an interviewer to 455 elderly diabetic patients aged > 65 years. To assess diabetes‐specific QOL, the EDBS was developed. The internal consistency and test–retest reliability of the EDBS were assessed. The validity of the EDBS was assessed with the correlation with the Philadelphia Geriatric Center morale scale, the mini‐mental state examination (MMSE) and diabetic complications, treatment of diabetes, hemoglobin (Hb) A1c, frequency of hypoglycemia, and socioeconomic factors.Results: Factor analysis of the 23 items on EDBS produced six reliable components (Cronbach's α): symptom burden (0.55), dietary restrictions (0.89), social burden (0.89), worry about diabetes (0.85), treatment dissatisfaction (0.85), and burden by tablets or insulin (0.77). It was found that the EDBS and its six subscales had good test–retest reliability (r = 0.94–0.99). However, the EDBS correlated significantly with the morale scale but not with MMSE, suggesting convergent and discriminant validity. The high scores of some subscales and total EDBS were significantly associated with high HbA1c level, frequency of hypoglycemia, and insulin therapy, showing construct validity. Multivariate analyses revealed that hyperglycemia, frequency of hypoglycemia, insulin treatment, the presence of microangiopathy, and low positive social support were independently associated with increased elderly diabetes burden scores.Conclusion: The EDBS is a simple but reliable and valid measure of diabetic‐specific QOL in elderly people with diabetes mellitus.