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.