The aim of the present study was to compare different prediabetes definitions and characterize the risks of prediabetes and diabetes among older adults. Material & methods: A random sample of all registered inhabitants aged ≥60 years living at home or in nursing homes were invited to the baseline assessment during the duration of 3 years. 500 diabetes-free participants were included in the study. Results: Women made up 56.8% of the research, comparing males. Average patient age was 75. All prediabetes criteria have positive predictive values < 12% for incidence complete diabetes. But all negative predictive values were 96% or above. Detecting confirmed diabetes was most sensitive for prediabetes with HbA1c values of 5.7%-6.4% or IFG (≥94%), while specificity was best for those with such levels and IFG (confirmatory definition). Positive predictive values for incident-diagnosed diabetes were below 8% and negative predictive values were 97% or higher. Alternative global definitions of prediabetes have a sensitivity of less than 48% for new total and diagnosed diabetes cases and a specificity of 78% or greater. Conclusion: The incidence of prediabetes was substantial; yet, during the duration of the trial, a greater number of individuals had a return to normal blood sugar levels or mortality compared to those who developed diabetes. These data indicate that prediabetes may not be a reliable diagnostic category in older individuals.