{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T01:41:24Z","timestamp":1771378884962,"version":"3.50.1"},"reference-count":86,"publisher":"American Diabetes Association","issue":"4","license":[{"start":{"date-parts":[[2017,3,21]],"date-time":"2017-03-21T00:00:00Z","timestamp":1490054400000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,4,1]]},"abstract":"<jats:sec>\n                  <jats:title\/>\n                  <jats:p>Older adults with diabetes are at higher risk for atherosclerotic cardiovascular disease (ASCVD) than younger adults with diabetes and older adults without diabetes. The rationale to implement ASCVD risk\u2013lowering therapies in older adults with diabetes is compelling. Recommendations for lifestyle modification, lipid-lowering therapy, blood pressure management, blood glucose control, and aspirin therapy are often based on studies that show their efficacy in younger populations. However, the risks associated with each of these interventions increase with age, and favorable risk-to-benefit ratios demonstrated in younger adults with diabetes are less certain in older populations. The variability in health status among older adults is pertinent. Those with robust health are more likely to tolerate and derive benefit from many therapies when compared with those who have more complex health including frailty. Age- and\/or frailty-stratified data to help clarify these relationships are sparse. In this Perspective, current recommendations for modifying ASCVD risk are described with a review of the pertinent literature that guides their application in older adults. A pragmatic approach to the treatment of ASCVD risk factors in older adults with diabetes is presented.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc16-0815","type":"journal-article","created":{"date-parts":[[2017,3,21]],"date-time":"2017-03-21T20:02:31Z","timestamp":1490126551000},"page":"476-484","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":10,"title":["Management of Atherosclerotic Cardiovascular Disease Risk Factors in the Older Adult Patient With Diabetes"],"prefix":"10.2337","volume":"40","author":[{"given":"Mary T.","family":"Korytkowski","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel E.","family":"Forman","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine and Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1167","published-online":{"date-parts":[[2017,3,10]]},"reference":[{"key":"2022031202142057400_B1","doi-asserted-by":"crossref","first-page":"2650","DOI":"10.2337\/dc12-1801","article-title":"Diabetes in older adults","volume":"35","author":"Kirkman","year":"2012","journal-title":"Diabetes Care"},{"key":"2022031202142057400_B2","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1001\/jama.2014.11494","article-title":"Prevalence and incidence trends for diagnosed diabetes among adults aged 20 to 79 years, United States, 1980-2012","volume":"312","author":"Geiss","year":"2014","journal-title":"JAMA"},{"key":"2022031202142057400_B3","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1161\/01.CIR.0000048893.62841.F7","article-title":"Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: part II: the aging heart in health: links to heart disease","volume":"107","author":"Lakatta","year":"2003","journal-title":"Circulation"},{"key":"2022031202142057400_B4","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1001\/archinte.167.9.921","article-title":"Longitudinal incidence and prevalence of adverse outcomes of diabetes mellitus in elderly patients","volume":"167","author":"Bethel","year":"2007","journal-title":"Arch Intern Med"},{"key":"2022031202142057400_B5","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1111\/j.1532-5415.2008.02150.x","article-title":"The co-occurrence of chronic diseases and geriatric syndromes: the Health and Retirement Study","volume":"57","author":"Lee","year":"2009","journal-title":"J Am Geriatr Soc"},{"key":"2022031202142057400_B6","doi-asserted-by":"crossref","first-page":"2578","DOI":"10.2337\/db14-0020","article-title":"Diabetes and cardiovascular disease in older adults: current status and future directions","volume":"63","author":"Halter","year":"2014","journal-title":"Diabetes"},{"key":"2022031202142057400_B7","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1001\/jamainternmed.2013.12956","article-title":"Rates of complications and mortality in older patients with diabetes mellitus: the Diabetes and Aging Study","volume":"174","author":"Huang","year":"2014","journal-title":"JAMA Intern Med"},{"key":"2022031202142057400_B8","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1111\/j.1447-0594.2012.00935.x","article-title":"Association of geriatric conditions and cardiovascular diseases with disability in older adults with diabetes: findings from a nationally representative survey","volume":"13","author":"Li","year":"2013","journal-title":"Geriatr Gerontol Int"},{"key":"2022031202142057400_B9","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.jcjd.2015.09.004","article-title":"Diabetes and frailty: two converging conditions?","volume":"40","author":"Sinclair","year":"2016","journal-title":"Can J Diabetes"},{"key":"2022031202142057400_B10","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1001\/jama.2016.0299","article-title":"Polypharmacy in the aging patient: a review of glycemic control in older adults with type 2 diabetes","volume":"315","author":"Lipska","year":"2016","journal-title":"JAMA"},{"key":"2022031202142057400_B11","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1016\/j.jacc.2011.05.020","article-title":"The effect of age on clinical outcomes and health status BARI 2D (Bypass Angioplasty Revascularization Investigation in Type 2 Diabetes)","volume":"58","author":"Chung","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"2022031202142057400_B12","doi-asserted-by":"crossref","first-page":"S81","DOI":"10.2337\/dc16-S013","article-title":"Older adults. 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