What factors predict life expectancy in a 92-year-old patient with type 2 diabetes (T2D), including duration of diabetes, reliance on a wheelchair, need for nursing home care/long-term care, and polypharmacy with medications such as insulin glargine (insulin glargine), insulin lispro (insulin lispro), metformin (metformin), and glipizide (glipizide)?

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From the Guidelines

The need for nursing home care/long term care is the most significant predictor of SD's life expectancy among the factors listed. Functional status and level of dependency are strong predictors of mortality in older adults, and SD's requirement for long-term care indicates significant functional impairment. While the other factors may contribute to overall health status, the need for institutional care reflects a comprehensive decline in function that encompasses multiple domains of health. SD's wheelchair dependence and impairment in all activities of daily living (ADLs) further support this assessment, as functional limitations strongly correlate with reduced life expectancy in the elderly 1. The duration of diabetes and polypharmacy (needing 3+ medications for diabetes) are less powerful predictors compared to functional status, though they do contribute to overall health burden. In geriatric assessment, functional status often outweighs specific disease diagnoses when estimating life expectancy, making the need for nursing home care the most relevant factor among those listed for predicting SD's life expectancy.

Some key points to consider in this assessment include:

  • The importance of functional status in predicting life expectancy in older adults 1
  • The impact of institutional care on health outcomes and life expectancy 1
  • The need to consider the patient's living situation and support needs when developing a care plan 1
  • The role of social and instrumental support networks in diabetes management and overall health 1

Overall, the need for nursing home care/long term care is a critical factor in predicting SD's life expectancy, and should be considered in conjunction with other factors such as functional status, duration of diabetes, and polypharmacy.

References

1
Guideline

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Dr.Oracle Medical Advisory Board & Editors, 2025

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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