Prevalence Rates of Diabetic Retinopathy and Undiagnosed Diabetes Among Delaware Nursing Home and Assisted Living Facility Residents

Abstract

Objectives: To determine the prevalence of diabetic retinopathy and undiagnosed diabetes among Delaware nursing home and assisted care facility residents. Methods: This cross-sectional study involved the statistical analysis of comprehensive eye examination records of 2,063 nursing home residents residing in 18 facilities and 4 assisted living facilities in Delaware from 2005 to 2009. Descriptive statistical analyses were conducted to identify the rates of retinal dot and blot hemorrhages and existing systemic diabetes diagnoses. Results: The mean age of nursing home and assisted care facility residents was 77 years (range 9-104), and 64.4% were over the age of 80. Most residents were female (61.1%) and white (72.5%). 3.6% of the 2,063 nursing home residents had blot or dot hemorrhages in one or both eyes. 32.8% had a type 1 or type 2 diabetes diagnosis. Of the ones with a positive dot and blot hemorrhage finding, 56.8% had a diagnosis of diabetes, and 43.2% did not. Discussion: There was a high prevalence of dot and blot hemorrhages without a systemic diagnosis of diabetes, indicating a need for regular eye care among residents.

Keywords: assisted living facility; coordinated interprofessional healthcare; diabetic retinopathy; nursing home; undiagnosed diabetes.

Figure 1.

Mechanisms of hyperglycemia-induced tissue modifications in microvascular diabetic disease. Source. Ahern et al. (1993); Brownlee (2005); Matthews(1999).

Figure 2.

Inflammation processes and affected ocular structures in diabetic retinopathy. Source. Rangasamy et al. (2012); Tang & Kern (2011).

Picture 1.

Non-proliferative diabetic retinopathy (dot and blot hemorrhages and hard exudates). Source. Robert Andersson (2023). Robert Andersson, Salus University

Picture 2.

Advanced-stage diabetic eye disease (PDR with PRP). Source. Robert Andersson (2023).