The objective of this study was to examine the association between adiposity, changes in adiposity, and risk of incident type 2 diabetes in adults 65 years of age and older. A total of 4,193 men and women from the Cardiovascular Health Study were analyzed during a median follow-up of 12.4 years with 339 cases of incident diabetes recorded. Results showed that measures of overall and central adiposity were strongly associated with the risk of incident diabetes in both men and women. Moreover, results revealed that simple anthropometric measures such as body mass index (BMI), body weight, and waist circumference were as strongly associated with the risk of diabetes as was fat mass estimates derived from bioelectrical impedance measures. The authors also reported that the risk of diabetes associated with adiposity was modified by age. Indeed, the relative risk of diabetes in individuals of the top tertile of the distribution of each adiposity variable was approximately 2-fold greater in participants 65 to 74 years of age compared to those older than 75 years of age. Moreover, a strong association was observed between waist circumference and diabetes risk in individuals with a BMI of less than 25. Finally, participants who gained ≥6 kg or increased waist circumference more than 10 cm had a 2-fold increased risk of diabetes. Thus, these findings indicate that there is an impact of overall and central adiposity on the risk of diabetes among older individuals.