Literature review

Diabetes refers to the health disorder that affects the health of individuals that causes higher blood sugar. Untreated higher blood glucose from diabetes can affect various body parts including the nervous system, eyes, kidneys and many more (Chan, et al., 2021). Older adults are more likely to suffer from diabetes conditions due to improper management of blood sugar and higher overweight also increase chances of diabetes (Brink, et al., 2019). Older adults suffering from diabetes conditions are more likely to suffer from stress, and an increase of cortisol that may also enhance the risk of schizophrenia and affect health negatively (Chan, et al., 2021). Older people suffering from diabetes are also associated with schizophrenia condition which increases serious health concerns and affects many body parts (Brink, et al., 2019). In the United Kingdom, around 33% of older adults aged 65 have diabetes and also suffer from schizophrenia circumstances. Exactly, excessive inactive lifestyle, opposing effects of antipsychotic, social determinants and limited accessibility of medical upkeep for older adults affect health and increase serious concerns of schizophrenia condition (Chan, et al., 2021). This research will provide depth insight into the comorbidity of diabetes and schizophrenia among older adults and also propose effective recommendations or health practices to manage such diseases. A literature review will be conducted to review previous findings or research papers related to schizophrenia and diabetes among older adults and address the research problems or gaps effectively. This proposed study will contribute to the healthcare systems that will help to improve knowledge and experience and also create effective health practices and programs to improve the health of older adults.

Abou, et al., (2019) reported that diabetes is one of the major health conditions among older adults that causes higher blood sugar. Older people are less capable to maintain blood sugar that increases serious diabetes conditions and also affect health or body parts negatively (Brink, et al., 2019). As compared to young people, older adults suffering from diabetes are more likely to have schizophrenia disorder that increases complexities to perform daily life activities (Chan, et al., 2021). In the United Kingdom, an estimated 34% of the adults aged above 64 or older have type 2 diabetes and also suffer from schizophrenia-related mental conditions (Etchecopar, et al., 2021). Older adults are less experienced about health issues and higher overweight or diabetes conditions increase heart disease, schizophrenia and other mental disorders (Abou, et al., 2019). Agarwal, et al., (2021) identified that schizophrenia is a serious mental condition and seen in one of four older adults suffering from type 2 diabetes that disable older people to think and perform daily life activities.

Impact of diabetes on older adults

In the UK, the rate of schizophrenia among older adults who have diabetes increased by 20% in the last two years and improper neurobiological mechanisms, mental conditions and genetic factors increase serious health concerns (Walker, 2022). It is observed that older adults with diabetes disorder containing schizophrenia conditions have excess morbidity and mortality leading to the decreased lifespan of 20 to 35 years as compared to the young adults or population (Agarwal, et al., 2021). The increased mortality among diabetes patients is largely attributable to physical and mental illness that directly increase the prevalence rate of schizophrenia disorder.

In the United Kingdom, there are limited health promotional programs and healthcare systems that are not capable for older people suffering from diabetes to reduce the rate of schizophrenia (Abou, et al., 2019). Ahearn, et al., (2020) agreed and stated that metabolic syndrome happens in one in four older adults experiencing diabetes and is also less capable to reduce the diagnosis of schizophrenia conditions. Diabetes is directly linked with overweight and chronic conditions due to which older adults can face psychiatric symptoms and cognitive deficits that also limits their social and mental functioning and increase schizophrenia disorder (Ho, et al., 2021). The alteration in diabetes occurrence among those with schizophrenia and the general population ornament linearly with older adults as compared to the young generation (Schuch, et al., 2021). Major three risk factors are identified among diabetes patients that increase the prevalence rate of schizophrenia among older adults including poor dieting plan, inactivity and antipsychotic utilization.

Figure: Diabetes and schizophrenia among older adults

(Source: Alyazeedi, et al., 2019)

Alyazeedi, et al., (2019) identified that lack of proper activities or dieting plans among older adults suffering from diabetes lead to increase mental health problems like schizophrenia. The findings show whether older patients who had diabetes disorder at the onset of schizophrenia are less lazy and not capable to perform daily life activities. Patients with schizophrenia are more likely to have higher blood glucose as compared with normal people that influence health and human body systems (Abou, et al., 2019). Type 2 diabetes is commonly associated with older adults rather than young people that also increase stress and depression related issues and increase the rate of schizophrenia disorder (Alyazeedi, et al., 2019). Brooks, et al., (2019) conducted literature and identified that older adults are not capable to gain proper information and knowledge regarding diabetes conditions that increase cognitive, emotional and behavioural problems.

In the United Kingdom, the diagnosis rate of type 2 diabetes among older adults has increased by 25% and also produced serious schizophrenia conditions (Lee, et al., 2021). It is true that diabetes can be seen in many schizophrenic patients without any antipsychotic medication and improper experience and health programs in the UK lead to increase serious mental conditions (Bitan, et al., 2021). Diabetes care in older adults with schizophrenia should be intensive and started earlier and it is important for the patients to prevent long term complications to deal with serious conditions. Chan, et al., (2021) agreed and stated that older patients with diabetes and schizophrenia conditions have multiple cardiovascular factors that increase hypertension and depression (Bendayan, et al., 2021). Proper diets and exercise plans are more effective and reliable for the older adults who are suffering from diabetes as dieting plans can help to maintain blood glucose and exercise can help to reduce body weight, stress and maintain life activities that positively decrease schizophrenia conditions (Chan, et al., 2021).

Figure: Impact of diabetes on older adults

(Source: Chan, et al., 2021)

In older adults with schizophrenia conditions, the issues of adherence and follow-up maybe even more challenging as compared to the general population (Alyazeedi, et al., 2019). The long-term risks of improper treatments against diabetes increase mortality and risks of schizophrenia disorder and older adults are less experienced and aware produce serious mental concerns (Abou, et al., 2019). The humanity rate of older adults with schizophrenia is higher, life expectancy is shorter by 10 to 15 years and diabetes is directly linked with schizophrenia that affects physical and mental activities negatively. Metabolic irregularities counting diabetes increase the rate of schizophrenia among older adults. Chung and Miller, (2020) stated that the prevalence of diabetes among older adults with schizophrenia may be epidemiologically recurrent because neuroleptics persuade weight gain as a side consequence.

The reasoning dysfunction of older patients with schizophrenia relates to a messy lifestyle, deprived diet, and short socioeconomic status and diabetes is a major condition associated with the poor diet and improper lifestyle that increase schizophrenia disorder (Abou, et al., 2019). Useful proteins interpreted from shared genetic vulnerability genes are known to control neuronal growth in the brain but diabetes increase chronic depression among older adults that also increase the risk of schizophrenia condition (Rodrigues, et al., 2021). As compared to the young people, older adults are less likely to maintain dieting, exercise plans and higher blood sugar affect both physical and mental health conditions. Major three factors are identified among older adults suffering from diabetes that increase schizophrenia conditions including lack of emotion, delusions and disordered thoughts (Lähteenvuo, et al., 2021). Due to such risk factors, diabetes older patients are not capable to perform daily life activities and mental health is affected through schizophrenia disorder.

According to Denis, et al., (2019) schizophrenia is related to important amplified morbidity and mortality. The normal life expectancy of an older adult with schizophrenia is 62.8 years in UK males and 70 years in UK females which is around 11 years earlier among older adults suffering from the diabetes disorder (Alyazeedi, et al., 2019). About 74% of all deaths in older adults with schizophrenia are caused by physical illness including chronic conditions, diabetes and cardiovascular conditions (Chen, et al., 2021). It is found that all major cardiovascular disorder risks factors, counting diabetes, are improved 2- to 3-fold in older adults with schizophrenia (Pieters, et al., 2021). Traditional risk aspects for diabetes disorder particularly being overweight or obese are directly associated with schizophrenia reduces the ability of older people to perform physical activities and increase mental health concerns (Denis, et al., 2019). It is assessed that 41% of older adults in the United Kingdom with schizophrenia had a body mass index over 27kg/m2 as compared to the general population which shows that diabetes has the capability to produce schizophrenia disorder among older people (Denis, et al., 2019). Older People with schizophrenia who progress with diabetes are in addition more vulnerable to the problems related to the latter.

Figure: Schizophrenia among older adults

(Source: Egglefield, et al., 2019)

Egglefield, et al., (2019) stated that older adults with diabetes are 74% more likely to produce schizophrenia conditions and affect health and daily life activities. Schizophrenia-related deaths among older adults in the UK are five times more frequent with type 2 diabetes which shows that dealing with the diabetes conditions requires proper promotional and healthcare programs for older adults to reduce the prevalence rate of diabetes and schizophrenia (Cheng, et al., 2021). It is found that type 1 diabetes is not associated with schizophrenia among older adults but type 2 diabetes is capable to affect the physical and mental activities of older people and increase the chances of schizophrenia (Tau, and Cohen, 2021). The higher occurrence of diabetes between older adults with schizophrenia reflects various factors covering sedentary lifestyle, improper knowledge and less accessibility of healthcare programs (Denis, et al., 2019).  

It is true that lack of knowledge among family members and older people about diabetes can leads to increase serious concerns and also affect mental health (Guerrero, et al., 2018). The presence of schizophrenia condition among older adults also increases the chances of death and they can face challenges to perform activities (Denis, et al., 2019). The occurrence of diabetes has been recognized to be higher in older adults with schizophrenia and older patients are less capable to defend against mental disorders and conditions (Abou, et al., 2019). Increasing awareness about diabetes and schizophrenia among older adults can lead to an increase in their health and also deal with serious concerns. Goueslard, et al., (2018) agreed and found that antipsychotic drugs are mainly identified from the older adults increasing the rate of type 2 diabetes and schizophrenia conditions. The presence of improper dieting and exercise-related concerns among older adults can lead to increase diabetes disorder and it is important for the healthcare communities to provide proper dieting plans to the patients (Goueslard, et al., 2018).

Through proper awareness and promotional programs, it is easy for the family members to motivate older adults for diets and exercise that can help to reduce the prevalence rate of diabetes and schizophrenia (Denis, et al., 2019). The diagnosis of older adults suffering from diabetes requires proper testing and promotional programs that can help to identify the problems faced by the older adults increasing schizophrenia disorder (Goueslard, et al., 2018). It is important for the healthcare communities in the UK build proper healthcare programs and plans for the older people facing both diabetes and schizophrenia conditions (Huang, et al., 2018). The testing process is more effective and reliable that can help older patients to rule out conditions with similar signs or symptoms and screen for diabetes and schizophrenia conditions (Denis, et al., 2019). Huo, et al., (2020) identified that diabetes is common among older adults with mental health concerns, mainly schizophrenia.

The rapid increase in the worldwide occurrence of diabetes is hitting a growing strain on health arrangements (Goueslard, et al., 2018). A connotation among schizophrenia and metabolic irregularities is well labelled, and older patients with schizophrenia have meaningfully higher rates of chronic conditions and diabetes issues as compared to the general population (Denis, et al., 2019). Moreover, psychiatric disease including schizophrenia is regularly allied with poor lifestyle selections that need to be managed and reduced to provide proper support to the patients.

The diagnosis of schizophrenia for older people can help to control and reduce diabetes-related concerns and provide better services to increase health and fitness (Denis, et al., 2019). Huong, et al., (2020) identified that it is important for the healthcare communities to focus on preventing diabetes among older adults through proper healthcare programs and plans. Intervention and diagnosis of diabetes-based risk factors from older people can help to manage the chances of schizophrenia conditions (Denis, et al., 2019). More than 60% of the older people suffering from diabetes also face the early signs or symptoms of schizophrenia disorder that should be diagnosed through antipsychotic prescription and proper intervention programs (Goueslard, et al., 2018).

Implementation of significant antipsychotic medicine, provision of passable motivation for stable diet and physical action and easing access to main health care may help in decreasing diabetes prevalence and also enable to diagnosis of schizophrenia (Lee, et al., 2019). Furthermore, population health agendas could help therapy and stop diabetes and schizophrenia risks and enable older adults to reduce the serious health concerns and mental concerns (Denis, et al., 2019). Ponirakis, et al., (2020) identified that a shared inherited vulnerability to both diabetes and schizophrenia among older adult has been assumed based on the observation that diabetes is a common disorder and also increase schizophrenia.

A common hereditary connection between diabetes and schizophrenia in older adults should be managed and reduced with the proper treatments and healthcare programs. The previous studies report abnormal glucose absorption and insulin gesturing in the brain suffering from schizophrenia (Lee, et al., 2019). Genes complicated in both glucose absorption and cognitive purpose may enhance the risk of schizophrenia in older adults suffering from diabetes (Zimering and Nadkarni, 2019). As compared to the young population, older people suffering from diabetes are at higher risk of schizophrenia and also increase the rate of deaths worldwide (Lee, et al., 2019). Older adults who are suffering from diabetes can leads to increase the risk of schizophrenia as diabetes increase sugar level and also affect both the mental and physical health of the patients which can increase schizophrenia conditions (Lee, et al., 2019). The presence of type 2 diabetes among older adults is also associated with schizophrenia that has the ability to reduce the lifespan of the patients up to 30 years which increases heart risks, stroke and other conditions (Zimering and Nadkarni, 2019).

Young people are capable to maintain dieting and physical activities in regard to diabetes also reduce the chances of schizophrenia condition but older adults are less capable to gain proper physical activities and chances of loneliness or stress negatively impact on their mental health (Lee, et al., 2019). Zimering and Nadkarni, (2019) identified that diagnosis of diabetes among older adults requires proper health care programs and promotional models that can enable the patients to understand the impact of diabetes and the role of dieting and physical activities. Older adults suffering from diabetes requires proper healthcare systems and it is important for the government to develop educational and awareness programs that can help older adults to control and manage diabetes and also help to decrease the risk of schizophrenia condition (Hugunin, et al., 2021).

A suitable treatment setting should be delivered by the healthcare communities to better engage with the older patients experiencing diabetes and schizophrenia (Lee, et al., 2019). In the United Kingdom, healthcare communities have developed health policies and strategies for the patients associated with diabetes and also suffer from schizophrenia conditions (Malig, et al., 2021). Older patients with diabetes should be understood and assessed occasionally to screen for schizophrenia and other cardiovascular health issues as diabetes is capable to increase other health disorders in the patients that need to be managed properly (Borovcanin, et al., 2021).

Aggressive lifestyle interferences must be employed for older adults with diabetes as proper lifestyle intervention can enable the older adults to connect with the real world and manage schizophrenia-related problems (Lee, et al., 2019). Schnitzer, et al., (2020) agreed and stated that metformin has the capability for lessening weight gain and averting diabetes and would be measured initial in at-risk patients. comorbidity studies of the older patients with diabetes have identified a positive relationship between the diabetes and schizophrenia that affect health and increase other cardiovascular and mental health conditions (Protsenko, et al., 2022). There is a significant relationship between diabetes and schizophrenia and older adults are more likely to have schizophrenia conditions who are experiencing diabetes disease (Zimering and Nadkarni, 2019).

Older adults with diabetes face various challenges and health risks and the metabolic risk influences of this multifactorial disease should be reviewed and managed by the patients that can help to diagnose against schizophrenia and diabetes (Chen, et al., 2021). A sympathetic the association among diabetes and schizophrenia, shared with information of operative treatment selections, permits the clinician to deliver more inclusive and sympathetic care to the older adults. It is found that diminished insulin sympathy is common in those diagnosed with schizophrenia who are associated with diabetes that needs to be evaluated and managed by healthcare professionals to reduce serious concerns (Bendayan, et al., 2022).

Current advances in sympathetic the congenital commonality among schizophrenia and diabetes opinion to three genomic districts among older adult (Zimering and Nadkarni, 2019). Behavioural aspects including an increased occurrence of smoking, chaotic sleep, idleness, and social separation are usually observed in the older adults with diabetes that are directly associated with the schizophrenia condition and increase the mental health problems among patients (Lee, et al., 2019). Therefore, it is important for diabetes patients to focus on physical activities and manage mental health conditions to deal with schizophrenia and other health diseases (Zimering and Nadkarni, 2019).

The major aim of this research is to critically evaluate the comorbidity of diabetes and schizophrenia among older adults. The rate of diabetes is increasing rapidly among older adults and also increase the rate of schizophrenia condition (Lee, et al., 2019). It is important to understand the relationship between diabetes and schizophrenia and how older adults suffering from diabetes face schizophrenia conditions. This research will conduct a literature review to analyze previous findings and research papers related to diabetes and schizophrenia disorders.

• To understand the impact of diabetes on older adults
• To review and evaluate the comorbidity of diabetes and schizophrenia among older adults
• To analyze diagnosis of schizophrenia among older adults who are suffering from the diabetes conditions

The research methodology is capable to deliver a way to understand the requirements and evaluate the research problems or questions effectively. Effective research plans or methodologies are capable to create effective models or frameworks to address the research problems and gaps (Lago, et al., 2021). Various types of methodologies are followed including research design, research approach, data gathering, sampling and data analysis. These methodologies are described below:

It is more suitable for the research that enables the writers to develop effective research plans and frameworks that help to resolve the investigate questions and difficulties easily. The major part of research design is that it creates proper plans for data collection and evaluation and also delivers a significant direction for the research. Soontornniyomkij, et al., (2019) identified that two types of designs are followed in the research including qualitative and quantitative designs. The term qualitative design refers to an effective methodology to gain theoretical information through observations. As compared to the qualitative design, quantitative research is more effective and reliable which helps to obtain numerical facts and statistics to increase research quality (Lee, et al., 2019).

This research will follow a quantitative design due to its potential to provide numerical facts and data collected from the statistical techniques (Zimering and Nadkarni, 2019). Using the quantitative design, it is easy to support theoretical information with statistical data and address the research problems identified. Moreover, such design will help to deal with diabetes and schizophrenia conditions among older adults and will address research questions effectively (Lee, et al., 2019).

An effective approach provides effective approaches and plans to complete the research within less time (Zimering and Nadkarni, 2019). Effective research approaches are capable to create data collection and analysis processes and enable the writers to reduce the research gaps and issues easily (Toender, et al., 2020). Various types of methods are added such as inductive and deductive approaches. In this manner, the inductive approach is capable to deliver depth insight in regards to diabetes and schizophrenia among older adults (Veeneman, et al., 2021). As opposed, the deductive approach is used to gather brief or limited information in the research and helps the writers to complete the investigation in less time (Zimering and Nadkarni, 2019).

This research will follow an inductive approach as it is able to deliver depth information about diabetes and schizophrenia among older adults and also helps to reduce the research problems effectively (Zimering and Nadkarni, 2019). As compared to the deductive approach, inductive is beneficial for the study to gain appropriate data and information without requiring to develop research hypotheses. Therefore, using such an approach will help to address research questions or problems and achieve the research objectives easily (Xing, et al., 2018).

It is a reliable and significant part of the research that has the ability to propose reliable research strategies to address questions and problems (Xing, et al., 2018). Various types of research strategies are included in the studies such as literature review, survey through questionnaires, interviews, case studies and many more (Xing, et al., 2018). The selection of research strategy is completely based on the research topic and questions and this research is related to diabetes and schizophrenia conditions among older adults. In this manner, two strategies will be followed such as literature review and survey through a questionnaire.

A literature review is an effective methodology that is capable to develop effective plans to gather reliable information and also evaluating the previous findings (Xing, et al., 2018). In this research, the literature review will be conducted for analyzing the research papers related to diabetes and schizophrenia disorders among older adults (Fabre, et al., 2021). A Google Scholar will help to select appropriate research papers and articles. Primary research is important to gather fresh information and address the problems related to the secondary data to gain depth insight (Xing, et al., 2018). As opposed, a survey through the questionnaire will be conducted to get primary information regarding diabetes and schizophrenia among older adults. the survey will help to understand the viewpoints of participants about how older adults experiencing diabetes can suffer from schizophrenia disorder. Therefore, using a survey and literature review, the research problems or questions will be addressed in a reliable manner and research objectives will be achieved in a significant manner.

Data collection has the capability to propose effective gathering plans for the research and complete the research within the given time period (Xing, et al., 2018). Using appropriate data collection, it is easy for the writers to collect or obtain reliable information and address the research questions (Zhang, et al., 2019). Two types of data gathering techniques are used such as primary and secondary. Primary data is mainly gathered from fresh resources including surveys, interviews and many more (Xing, et al., 2018). As opposed, secondary data is gathered using literature review, case studies and other resources (Sazhin, and Pushkal, 2021). It is true that selecting reliable data and resources in the research can lead to rise study excellence and addresses study problems in less time (Xing, et al., 2018).

This research will include both primary and secondary data gathering where primary statistics will be collected through a survey and secondary data will be obtained using a literature review. The primary data will help to obtain effective and reliable information from participants using surveys through a questionnaire. The survey will be developed based on diabetes and schizophrenia among older adults and will be shared with the participants to obtain their viewpoints (Mansur, et al., 2021). As opposed, secondary data will be collected through a literature review that has the ability to review the previous findings so that effective information can be gathered and research gaps can be minimized. Therefore, using such methods, effective facts and information will be gathered that will help to achieve the research aim and objectives in less time.

Sampling refers to the technique to select reliable members for the primary study from the larger populace (Xing, et al., 2018). With the help of an effective sampling process, it is easy to develop and implement primary research and gather appropriate information from the participants (Zimering, and Nadkarni, 2019). Generally, two types techniques are followed including random sampling and non-random sampling. Random sampling is used in the studies to gather participants without requiring any specific criteria and randomly select participants for the primary research (Choi, et al., 2021). Using random sampling techniques, biasing and ethical problems associated with the participants and research can be minimized easily. As opposed, non-random sampling is used for gaining proper and effective participants using a research criterion that can affect research and also increase complexity in the data collection methods.

This study will follow a random sampling method as it is talented to deliver effective and suitable participants for the primary research (Zimering and Nadkarni, 2019). Moreover, random sampling will help to reduce ethical and biasing issues from the research by which depth insight about the research problem can be obtained. In this manner, 20 participants will be selected from the healthcare systems to understand the relationship between diabetes and schizophrenia among older adults (Xing, et al., 2018). In this manner, various data or information will be included including age of the participants, experience, gender, and technical questions related to diabetes and schizophrenia among older adults. Moreover, the survey will be conducted and shared with the participants using an email server that will help to collect responses from the participants and address research problems.

Data analysis plays a major contribution in the study that has the ability to create effective analytical programs and enables to the extraction of effective information from the collected data (Xing, et al., 2018). Various types of data analysis techniques are used such as content analysis, thematic analysis, statistical and many more. It is observed that the selected data analysis is based on the data collection methods. In this research, a quantitative design will be followed that will provide numerical facts and data related to diabetes and schizophrenia among older adults (Zimering and Nadkarni, 2019). So, this research will follow statistical analysis as it is capable to review and evaluate the numerical data in a reliable manner and providing better findings. With the help of statistical techniques, the collected data will be reviewed effectively and reliable findings or results will be obtained to address the research problems and questions (Zhang, et al., 2019). Moreover, the SPSS tool will be accessed in order to represent findings into tables with proper correlation and mean that can help to increase research quality (Zhang, et al., 2019). Therefore, it is true that using statistical analysis based on the SPSS tool will help to extract effective information in regards to diabetes and schizophrenia among older adults and will also draw a significant conclusion (Xing, et al., 2018). All these are reliable and beneficial methodologies and techniques for the research by which aims and objectives will be attained within the given time period and problems will be addressed effectively.

Ethical consideration is an important section of the research that helps to ensure that ethical problems are identified and addressed from the study so that quality and effectiveness can be maintained. In this research, an ethical consideration form will be submitted to the university as per the provided template or guidelines. The ethical form will cover the complete information about the research topic, aims and objectives, research plans, data collection and analysis activities that will help to ensure that only authentic and ethical sources will be included in the research. Copyright is one of the major concerns associated with research and writing that can affect research quality and increase ethical problems. However, this research will follow copyright laws and legislations and will collect data from authentic sources. Moreover, plagiarism will be reduced and writing will be done as per the provided guidelines that will help to complete the research within the deadline. The literature review will review viewpoints of previous writers that will help to improve research quality and reduce research gaps. In this manner, in-text citations will be included in every paragraph of the research that will indicate that the included information or facts are obtained from authentic sources. Moreover, other writers will be capable to get proper credit from their previous studies and will manage the ethical concerns. A reference list will be added in the research that will contain the complete information of the research articles or peer-reviewed papers used in the literature and will enable the readers to access the complete information or papers to gain knowledge or experience. Therefore, all these are effective strategies and ways to deal with the ethical problems from the research and will ensure that data collection and data analysis activities will be completed in a significant manner and will maintain copyright or plagiarism related problems.

The work plan is beneficial to understand and review the various sections and subsections of the research and effective time or efforts can be provided to the research. In this research, aims and objectives will be proposed and submitted to the supervisor for getting confirmation about the research problems and themes. An introduction or overview of the research will be provided to understand the significance of the investigation. Moreover, the literature review will be conducted based on the research questions and problems that will help to evaluate previous findings and journal papers. Effective research methodologies will be proposed that will help to get the right direction for the research and propose effective data collection approaches. Primary data will be collected using a survey through a questionnaire where a monkey survey will be used for creating the survey and will be shared with the participants using email servers. The collected responses or data will be analyzed and evaluated to get better findings or outcomes.

Moreover, a draft will be submitted to the supervisor to get feedback on the research and will change as per the provided feedback. After that final report will be submitted to the supervisor.

In this research, various resources or tools will be used to conduct the investigation and address the identified research problems. These resources include Microsoft Word, Excel, SPSS tool, Monkey Survey, Google Scholar, email-based communication servers and many more. Microsoft word is one of the major resources that will help to create research plans, proposals and reports based on the initial requirement. Using Microsoft Word, it is easy to develop an effective and reliable research proposal or dissertation where the formatting issues, heading problems and content writing-related issues can be minimized effectively. Excel is another tool that will be accessed to create tables, charts or figures based on the collected data that will help to represent theoretical information into the tables. Moreover, Excel will help to increase research quality by including graphs, figures and charts that will enable the readers to easily understand the findings or data. SPSS is an effective and reliable resource for the research that will be accessed to represent the findings or collected data from the participants with proper mean values and correlation factors. Using the SPSS tool, the relationship between the dependent variables will be identified and proper correlation with the research questions and objectives will be proposed. Google Scholar is one of the important resources used in the research that helps to select research articles and peer-reviewed papers related to diabetes and schizophrenia among older adults. Using Google Scholar, it is easy to gather the latest journal papers in less time and in terms of cost, Google Scholar is an open-source that can be accessed freely and data can be obtained in less time. The email will be used as a communication platform that will help to share the survey with the participants and proper responses can be obtained by which the data analysis activities can be performed. Therefore, all these are major resources that will be accessed in the research to achieve research aims and objectives.

Conclusion

From the above research, it may be concluded that diabetes is a common disorder among older adults and also increase the chances of schizophrenia among patients suffering from the diabetes. This research delivered a platform to understand relation between diabetes and schizophrenia among older adults. It is expected that the conducted research will address research problems and will provides depth insight about diagnosis of schizophrenia patients who are experiencing diabetes disease. The primary data will help to support findings and will also manage the research gaps and problems. It is found that older people suffering from diabetes are also associated with schizophrenia condition which increases serious health concerns and affects many body parts.

In UK, the rate of schizophrenia among older adults who have diabetes increased by 20% in last two years and improper neurobiological mechanism, metal conditions and genetic factors increase serious health concerns (Zhang, et al., 2019). The alteration in diabetes occurrence among those with schizophrenia and the general population ornament linearly with older adults as compared to the young generation (Schnitzer, et al., 2020). Diabetes care in older adults with schizophrenia should be intensive and started earlier and it is important for the patients to prevent long term complications to deal with serious conditions. The humanity rate of older adults with schizophrenia is higher, and life expectancy is shorter by 10 to 15 years and diabetes is directly linked with the schizophrenia that affects physical and mental activities negatively (Brink, et al., 2019). As compared to young people, older adults are less likely to maintain dieting, exercise plans and higher blood sugar affect both physical and mental health conditions (Xing, et al., 2018). It is found that type 1 diabetes is not associated with schizophrenia among older adults but type 2 diabetes is capable to affect the physical and mental activities of older people and increase the chances of schizophrenia (Brink, et al., 2019). The presence of improper dieting and exercise-related concerns among older adults can lead to increase diabetes disorder. The diagnosis of schizophrenia for older people can help to control and reduce diabetes-related concerns and provide better services to increase health and fitness. Using the quantitative design, it is easy to support theoretical information with statistical data and address the research problems identified. Moreover, such design will help to deal with diabetes and schizophrenia conditions among older adults and will address research questions effectively. A survey through the questionnaire will be conducted to get primary information regarding diabetes and schizophrenia among older adults (Brink, et al., 2019). the survey will help to understand the viewpoints of participants about how older adults experiencing diabetes can suffer from the schizophrenia disorder. It is expected that the findings will reduce the research gaps and problems effectively and diagnosis of schizophrenia and diabetes will be proposed in a reliable manner. The selected methodologies and techniques are more effective and beneficial to complete the research within the time period.

References

Abou Kassm, S., Hoertel, N., Naja, W., McMahon, K., Barrière, S., Blumenstock, Y., Portefaix, C., Raucher-Chéné, D., Béra-Potelle, C., Cuervo-Lombard, C. and Guerin-Langlois, C., 2019. Metabolic syndrome among older adults with schizophrenia spectrum disorder: Prevalence and associated factors in a multicenter study. Psychiatry research, 275, pp.238-246.

Agarwal, S.M., Panda, R., Costa-Dookhan, K.A., MacKenzie, N.E., Treen, Q.C., Caravaggio, F., Hashim, E., Leung, G., Kirpalani, A., Matheson, K. and Chintoh, A.F., 2021. Metformin for early comorbid glucose dysregulation and schizophrenia spectrum disorders: a pilot double-blind randomized clinical trial. Translational psychiatry, 11(1), pp.1-9.

Agarwal, S.M., Panda, R., Costa-Dookhan, K.A., MacKenzie, N.E., Treen, Q.C., Caravaggio, F., Hashim, E., Leung, G., Kirpalani, A., Matheson, K. and Chintoh, A.F., 2021. Metformin for early comorbid glucose dysregulation and schizophrenia spectrum disorders: a pilot double-blind randomized clinical trial. Translational psychiatry, 11(1), pp.1-9.

Ahearn, E.P., Szymanski, B.R., Chen, P., Sajatovic, M., Katz, I.R. and McCarthy, J.F., 2020. Increased risk of dementia among veterans with bipolar disorder or schizophrenia receiving care in the VA health system. Psychiatric Services, 71(10), pp.998-1004.

Alyazeedi, A., Algendy, A.F., Sharabash, M. and Karawia, A., 2019. Prevalence, determinants and associated risk of potentially inappropriate prescribing for older adults in Qatar: a National Retrospective Study. Clinical interventions in aging, 14, p.1889.

Bendayan, R., Kraljevic, Z., Shaari, S., Das-Munshi, J., Leipold, L., Chaturvedi, J., Mirza, L., Aldelemi, S., Searle, T., Chance, N. and Mascio, A., 2022. Mapping multimorbidity in individuals with schizophrenia and bipolar disorders: evidence from the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLAM BRC) case register. BMJ open, 12(1), p.e054414.

Bendayan, R., Mascio, A., Stewart, R., Roberts, A. and Dobson, R.J., 2021. Cognitive Trajectories in Comorbid Dementia With Schizophrenia or Bipolar Disorder: The South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) Case Register. The American Journal of Geriatric Psychiatry, 29(6), pp.604-616.

Bitan, D.T., Kridin, K., Cohen, A.D. and Weinstein, O., 2021. COVID-19 hospitalisation, mortality, vaccination, and postvaccination trends among people with schizophrenia in Israel: a longitudinal cohort study. The Lancet Psychiatry, 8(10), pp.901-908.

Borovcanin, M.M., Radosavljevic, G.D., Pantic, J., Milovanovic, J., Mijailovic, N.R., Arsenijevic, A.N. and Arsenijevic, N.N., 2021. Contrasting Roles of the Galectin-3 in the Schizophrenia Onset, Clinical Presentation, and Somatic Comorbidity. Current Topics in Medicinal Chemistry, 21(16), pp.1471-1487.

Brink, M., Green, A., Bojesen, A.B., Lamberti, J.S., Conwell, Y. and Andersen, K., (2019) Excess medical comorbidity and mortality across the lifespan in schizophrenia.: A nationwide Danish register study. Schizophrenia Research, 206, pp.347-354.

Brooks, J.M., Blake, J., Sánchez, J., Mpofu, E., Wu, J.R., Chen, X., Nauser, J., Cotton, B.P. and Bartels, S.J., 2019. Self-reported pain intensity and depressive symptoms among community-dwelling older adults with schizophrenia spectrum disorders. Community mental health journal, 55(8), pp.1298-1304.

Chan, J.K.N., Wong, C.S.M., Or, P.C.F., Chen, E.Y.H. and Chang, W.C., (2021) Risk of mortality and complications in patients with schizophrenia and diabetes mellitus: population-based cohort study. The British Journal of Psychiatry, 219(1), pp.375-382.

Chan, J.K.N., Wong, C.S.M., Or, P.C.F., Chen, E.Y.H. and Chang, W.C., 2021. Risk of mortality and complications in patients with schizophrenia and diabetes mellitus: population-based cohort study. The British Journal of Psychiatry, 219(1), pp.375-382.

Chen, C., Chan, H.Y., Yeh, L.L. and Pan, Y.J., 2021. Longitudinal factors associated with mortality in older patients with mood disorders. Journal of Affective Disorders, 278, pp.607-613.

Chen, E., Bazargan-Hejazi, S., Ani, C., Hindman, D., Pan, D., Ebrahim, G., Shirazi, A. and Banta, J.E., 2021. Schizophrenia hospitalization in the US 2005–2014: Examination of trends in demographics, length of stay, and cost. Medicine, 100(15).

Cheng, J.S., Hu, J.H., Chang, M.Y., Lin, M.S., Ku, H.P., Chien, R.N. and Chang, M.L., 2021. Hepatitis C–associated late-onset schizophrenia: a nationwide, population-based cohort study. Journal of Psychiatry and Neuroscience, 46(6), pp.E583-E591.

Choi, J.W., Lee, K.S. and Han, E., 2021. Suicide risk within 1 year of dementia diagnosis in older adults: a nationwide retrospective cohort study. Journal of psychiatry and neuroscience, 46(1), pp.E119-E127.

Chung, J. and Miller, B.J., 2020. Meta-analysis of comorbid diabetes and family history of diabetes in non-affective psychosis. Schizophrenia research, 216, pp.41-47.

Denis, F., Milleret, G., Wallenhorst, T., Carpentier, M., Rude, N. and Trojak, B., 2019. Oral health in schizophrenia patients: a French multicenter cross-sectional study. La Presse Médicale, 48(2), pp.e89-e99.

Egglefield, K., Cogan, L., Leckman-Westin, E. and Finnerty, M., 2020. Antipsychotic medication adherence and diabetes-related hospitalizations among medicaid recipients with diabetes and schizophrenia. Psychiatric Services, 71(3), pp.236-242.

Etchecopar-Etchart, D., Korchia, T., Loundou, A., Llorca, P.M., Auquier, P., Lançon, C., Boyer, L. and Fond, G., 2021. Comorbid major depressive disorder in schizophrenia: A systematic r

Fabre, C., Pauly, V., Baumstarck, K., Etchecopar-Etchart, D., Orleans, V., Llorca, P.M., Blanc, J., Lancon, C., Auquier, P., Boyer, L. and Guillaume, F.O.N.D., 2021. Pregnancy, delivery and neonatal complications in women with schizophrenia: a national population-based cohort study. The Lancet Regional Health-Europe, 10, p.100209.

Goueslard, K., Petit, J.M., Cottenet, J., Chauvet-Gelinier, J.C., Jollant, F. and Quantin, C., 2018. Increased risk of rehospitalization for acute diabetes complications and suicide attempts in patients with type 1 diabetes and comorbid schizophrenia. Diabetes Care, 41(11), pp.2316-2321.

Guerrero Fernández de Alba, I., Gimeno-Miguel, A., Poblador-Plou, B., Gimeno-Feliu, L.A., Ioakeim-Skoufa, I., Rojo-Martínez, G., Forjaz, M.J. and Prados-Torres, A., 2020. Association between mental health comorbidity and health outcomes in type 2 diabetes mellitus patients. Scientific reports, 10(1), pp.1-9.

Ho, I.S.S., Azcoaga-Lorenzo, A., Akbari, A., Black, C., Davies, J., Hodgins, P., Khunti, K., Kadam, U., Lyons, R.A., McCowan, C. and Mercer, S., 2021. Examining variation in the measurement of multimorbidity in research: a systematic review of 566 studies. The Lancet Public Health, 6(8), pp.e587-e597.

Huang, C.J., Hsieh, H.M., Tu, H.P., Jiang, H.J., Wang, P.W. and Lin, C.H., 2018. Schizophrenia in type 2 diabetes mellitus: Prevalence and clinical characteristics. European Psychiatry, 54, pp.102-108.

Hugunin, J., Yuan, Y., Rothschild, A.J., Lapane, K.L. and Ulbricht, C.M., 2021. Risk factors associated with suicidal ideation in newly admitted working-age nursing home residents. Journal of affective disorders, 295, pp.243-249.

Huo, L., Zhang, G., Du, X.D., Jia, Q., Qian, Z.K., Chen, D., Xiu, M., Wu, F., Soares, J.C., Huang, X. and Cassidy, R.M., 2020. The prevalence, risk factors and clinical correlates of diabetes mellitus in Chinese patients with schizophrenia. Schizophrenia research, 218, pp.262-266.

Huong, T.T.P., Kato, M., Shogenji, M., Tsujiguchi, H. and Taniguchi, Y., 2020. Examining the factors of burden among family caregivers of older adults with diabetes mellitus regarding a development model. J Wellness Health Care, 44, pp.19-30.

Lago, S.G., Tomasik, J., van Rees, G.F., Rubey, M., Gonzalez-Vioque, E., Ramsey, J.M., Haenisch, F., Broek, J.A., Vázquez-Bourgon, J., Papiol, S. and Suarez-Pinilla, P., 2021. Exploring cellular markers of metabolic syndrome in peripheral blood mononuclear cells across the neuropsychiatric spectrum. Brain, Behavior, and Immunity, 91, pp.673-682.

Lähteenvuo, M., Batalla, A., Luykx, J.J., Mittendorfer?Rutz, E., Tanskanen, A., Tiihonen, J. and Taipale, H., 2021. Morbidity and mortality in schizophrenia with comorbid substance use disorders. Acta Psychiatrica Scandinavica, 144(1), pp.42-49.

Lee, E.E., Sears, D.D., Liu, J., Jin, H., Tu, X.M., Eyler, L.T. and Jeste, D.V., 2019. A novel biomarker of cardiometabolic pathology in schizophrenia?. Journal of psychiatric research, 117, pp.31-37.

Lee, T.C., Wu, B.J., Yu, C.H. and Wang, T.J., 2021. Nonalcoholic fatty liver disease among long-term hospitalized patients with schizophrenia in a public psychiatric hospital. Taiwanese Journal of Psychiatry, 35(4), p.197.

Malig, B.J., Fairley, D., Pearson, D., Wu, X., Ebisu, K. and Basu, R., 2021. Examining fine particulate matter and cause-specific morbidity during the 2017 North San Francisco Bay wildfires. Science of The Total Environment, 787, p.147507.

Mansur, R.B., Delgado-Peraza, F., Subramaniapillai, M., Lee, Y., Iacobucci, M., Nasri, F., Rodrigues, N., Rosenblat, J.D., Brietzke, E., Cosgrove, V.E. and Kramer, N.E., 2021. Exploring brain insulin resistance in adults with bipolar depression using extracellular vesicles of neuronal origin. Journal of psychiatric research, 133, pp.82-92.

Pieters, L.E., Deenik, J., Tenback, D.E., van Oort, J. and van Harten, P.N., 2021. Exploring the relationship between movement disorders and physical activity in patients with schizophrenia: an actigraphy study. Schizophrenia Bulletin, 47(4), pp.906-914.

Ponirakis, G., Ghandi, R., Ahmed, A., Gad, H., Petropoulos, I.N., Khan, A., Elsotouhy, A., Vattoth, S., Alshawwaf, M.K., Khoodoruth, M.A.S. and Ramadan, M., 2022. Abnormal corneal nerve morphology and brain volume in patients with schizophrenia. Scientific reports, 12(1), pp.1-9.

Protsenko, M., Kerkelä, M., Miettunen, J., Auvinen, J., Järvelin, M.R., Jones, P.B., Gissler, M. and Veijola, J., 2022. Cardiometabolic Disorders in the Offspring of Parents With Severe Mental Illness. Psychosomatic medicine, 84(1), pp.2-9.

Rodrigues, M., Wiener, J.C., Stranges, S., Ryan, B.L. and Anderson, K.K., 2021. The risk of physical multimorbidity in people with psychotic disorders: A systematic review and meta-analysis. Journal of Psychosomatic Research, 140, p.110315.

Sazhin, V. and Pushkal, P., 2021. Predictors of laxative use in inpatients with schizophrenia on clozapine. Australasian Psychiatry, p.10398562211042368.

Schnitzer, K., Cather, C., Thorndike, A.N., Potter, K., Freudenreich, O., MacLaurin, S., Vilme, M., Dechert, A., Wexler, D. and Evins, A.E., 2020. Improved glycemic control in adults with serious mental illness and diabetes with a behavioral and educational intervention. Psychiatric Services, 71(7), pp.730-733.

Schuch, F.B., Bulzing, R.A., Meyer, J., López-Sánchez, G.F., Grabovac, I., Willeit, P., Vancampfort, D., Caperchione, C.M., Sadarangani, K.P., Werneck, A.O. and Ward, P.B., 2021. Moderate to vigorous physical activity and sedentary behavior changes in self-isolating adults during the COVID-19 pandemic in Brazil: a cross-sectional survey exploring correlates. Sport sciences for health, pp.1-9.

Soontornniyomkij, V., Lee, E.E., Jin, H., Martin, A.S., Daly, R.E., Liu, J., Tu, X.M., Eyler, L.T. and Jeste, D.V., 2019. Clinical correlates of insulin resistance in chronic schizophrenia: relationship to negative symptoms. Frontiers in psychiatry, 10, p.251.

Tau, M. and Cohen, C., 2021. Assertive Community Treatment Level Services for Older Adults with Severe Mental Illness: Exploration of Practitioners’ Perspectives. Journal of Psychosocial Rehabilitation and Mental Health, pp.1-10.

Toender, A., Vestergaard, M., Munk-Olsen, T., Larsen, J.T., Kristensen, J.K. and Laursen, T.M., 2020. Risk of diabetic complications and subsequent mortality among individuals with schizophrenia and diabetes-a population-based register study. Schizophrenia Research, 218, pp.99-106.

Veeneman, R.R., Vermeulen, J.M., Abdellaoui, A., Sanderson, E., Wootton, R.E., Tadros, R., Bezzina, C.R., Denys, D., Munafò, M.R., Verweij, K.J. and Treur, J.L., 2022. Exploring the relationship between schizophrenia and cardiovascular disease: a genetic correlation and multivariable mendelian randomization study. Schizophrenia bulletin, 48(2), pp.463-473.

Walker, V.G., 2022. Elder’s Life Course Theory and Person?Centered Research: A Lens for Conducting Ethical Nursing Research and Mental Health Nursing Practice with Older Adults Aging with the Diagnosis of Schizophrenia. Journal of Psychiatric and Mental Health Nursing.

Xing, S., Kim, S., Schumock, G.T., Touchette, D.R., Calip, G.S., Leow, A.D. and Lee, T.A., 2018. Risk of diabetes hospitalization or diabetes drug intensification in patients with depression and diabetes using second-generation antipsychotics compared to other depression therapies. The Primary Care Companion for CNS Disorders, 20(3), p.23237.

Zhang, X., Yang, M., Du, X., Liao, W., Chen, D., Fan, F., Xiu, M., Jia, Q., Ning, Y., Huang, X. and Wu, F., 2020. Glucose disturbances, cognitive deficits and white matter abnormalities in first-episode drug-naive schizophrenia. Molecular psychiatry, 25(12), pp.3220-3230.

Zimering, M.B. and Nadkarni, S.G., 2019. Schizophrenia Plasma Autoantibodies Promote ‘Biased Agonism’at the 5-Hydroxytryptamine 2A Receptor: Neurotoxicity is Positively Modulated by Metabotropic Glutamate 2/3 Receptor Agonism. Endocrinology, diabetes and metabolism journal, 3(4).