1222-P: An Examination of Frailty as Measured via Deficit Accumulation in African American Adults with Diabetes and Prediabetes

Abstract

Type 2 diabetes increases the accumulation of health deficits and has been described to be connected to accelerated biological aging. We utilized a frailty index (FI) in African Americans with prediabetes and diabetes modeled after the deficit accumulation index approach used in the Action for Health in Diabetes (Look AHEAD) Trial. This metric of frailty is comprised of 32 functional, behavioral, and clinical characteristics using the Jackson Heart Study (JHS) public access dataset. JSH is a large, community-based, observational study investigating the causes of cardiovascular disease (CVD) in 5301 African-Americans from Jackson, MS. Our study included 1339 adults aged 40-84 with prediabetes and diabetes who had over 12 years of follow-up for incident CVD events. Obese individuals, older individuals, those with poorer diabetes control, and hypertension had significantly higher mean FI scores than those without these characteristics. Approximately 34% of this sample was frail and 66% not frail. Compared with non-frail participants, stroke, heart failure, and coronary heart disease incidence of frail participants were increased. Frailty was an independent predictor of 12-year stroke (adjusted hazard ratio (HR): 6.84; 95% confidence interval (CI): 3.09 to 15.12), heart failure (adjusted HR: 3.00; 95% CI: 1.77 to 5.09), and coronary heart disease (adjusted HR: 2.48; 95% CI: 1.44 to 4.15) after adjusting for age and gender. Frailty is prevalent among African Americans with diabetes and prediabetes and is a predictor cardiovascular outcome. Frail adults with diabetics have an even higher risk of CVD, compared to non-frail adults with diabetes. Disclosure F.Simpson: None. A.Bertoni: None.