الفهرس 
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Abstract
The elderly age group is defined as people with chronological age of 65 years and more. The world’s population of people aged 60 years, and more is predicted to reach 2 billion by 2050, compared to 900 million in 2015.
Diabetes mellitus (DM) is a complicated chronic metabolic disorder characterised by elevated plasma glucose levels as well as disruptions in carbohydrate, lipid, and protein metabolism. In the future decades, the number of elderly persons with DM is predicted to rapidly rise. Polypharmacy, CI, depression, urine incontinence, injurious falls, and persistent pain are all more likely in older persons with DM.
Renal insufficiency is one of the most common microvascular consequences of DM. It is characterized by chronic inflammation and is linked to a much higher risk of death. Diabetic kidney disease (DKD) has become the leading cause of CKD in the older population around the world due to the increased prevalence of DM. The definition of DKD is, albuminuria (urinary albumin/creatine ratio UACR >30mg/g), an impaired glomerular filtration rate (eGFR < 60ml/min per 1.73 m2), or both.
24% of all occurrences of CI without dementia are caused by chronic medical problems. DM increased the risk of MCI by 21%. The prevalence of CI in end stage renal diseases (ESRD) is double than that of the normal population.
Physical and social functioning, as well as reported physical and mental well-being, are used to assess HRQoL. Patients with DM have a lower quality of life (QoL) compared to healthy subjects. DM as a cause of CKD may impact QOL independently of its negative effect on renal function. Lower eGFR and increased albuminuria are strongly associated with decrease in HRQoL.
The aim of the study primarily was to estimate the prevalence of CI in elderly T2DM patients with and without renal impairment and assess the quality of life of elderly T2DM patients with and without renal impairment. The secondary objective was to assess the factors associated with CI in patients with T2DM & renal impairment; Body Mass Index (BMI), high cholesterol etc.
This study included 180 cases aged 65 years and above, all recruited from the outpatient Geriatric and Nephrology clinics or hospitalized patients in the Geriatric and Nephrology units, Faculty of Medicine, Alexandria University. Participants were subdivided in to 3 groups, each group consisting of 60 individuals, patients with severe life-threatening infection or illness and severe dementia were excluded from the study.
• group (1): elderly T2DM without renal impairment.
• group (2): elderly T2DM with renal impairment.
• group (3): elderly healthy subjects.
All patients included in the study were subjected to detailed history taking, physical examination including BMI and systolic blood pressure, comprehensive geriatric assessment, laboratory examination, abdominal ultrasound and HRQoL questionnaires using Euro QoL-5D-3L.