Multidimensional Determinants of Quality of Life in Older Adults with Type 2 Diabetes: A Narrative Synthesis.
OBJECTIVES To synthesize evidence on determinants of quality of life (QoL) among older adults with type 2 diabetes mellitus (T2DM) within an aging-relevant biopsychosocial framework. METHODS A narrative review was conducted using Scopus. The search was performed in September 2025 and included peer-reviewed articles published between 2007 and 2025. Eligible studies examined QoL or health-related QoL among adults aged 60 years and older with T2DM. Screening was conducted independently by two reviewers, with disagreements resolved by consensus. Forty-eight studies met the inclusion criteria and were synthesized narratively. RESULTS The included studies varied in design, region, and QoL measurement. QoL was shaped by interconnected clinical, psychological, cognitive, functional, behavioral, pharmacological, social, and sociodemographic determinants. Greater clinical and treatment-related burden, depression, diabetes-related distress, cognitive impairment, functional limitation, and reduced mobility were generally linked with poorer QoL. Self-management, physical activity, treatment adherence, caregiver competence, and social support were generally linked with better QoL. CONCLUSIONS QoL in later-life diabetes reflects interactions among disease burden, emotional and cognitive vulnerability, functional capacity, self-management, and social-caregiving context. CLINICAL IMPLICATIONS QoL-oriented care should include psychological, cognitive, medication, functional, and social-caregiving assessment, alongside age-sensitive self-management support.