To the Editor We read the excellent cohort study by Rooney et al1 with great enthusiasm and appreciation, considering that there are few clinical trials designed to guide clinical decision-making among older adults with prediabetes and diabetes.2 The authors followed the Atherosclerosis Risk in Communities (ARIC) cohort and found that participants between 71 and 90 years old with prediabetes were more likely to regress to normoglycemia or die than progress to diabetes. This is an important study that may revolutionize the way we define and manage prediabetes in older adults; however, several limitations should be noted.