Fatigue-Related Factors for Community-Dwelling Older Adults with Diabetes: A Theory-Guided Multi-Dimensional Approach Using the Dynamic Biopsychosocial Model.

Hyerang Kim,Heesook Son

doi:10.3390/ijerph16224502

Abstract

Older adults with diabetes appear more susceptible to fatigue compared to younger adults with diabetes or healthy older adults, since aging and diabetes independently and synergistically influence fatigue. Few studies have investigated fatigue in older adults with diabetes using a multidimensional approach. This study explored the influences of physical, psychological, interpersonal, and contextual factors on diabetes fatigue using a dynamic biopsychosocial model. Face-to-face surveys were administered to community-dwelling older adults with diabetes and included variables across four domains (i.e., physical, psychological, interpersonal, and contextual factors). Univariate analyses and multiple linear regression were used. The mean fatigue score was 3.94 (standard deviation (SD) = 1.81) out of 7, and the prevalence of fatigue was 48.8%. Significant differences in fatigue severity by psychological, interpersonal, and contextual factors were found. Comorbidity and psychological factors were significant predictors of fatigue in the model, explaining 31.9% of the variance. As nearly half the sample experienced moderate or severe fatigue, which was significantly influenced by both comorbidity and psychological factors, including depression, sleep quality, and diet-related psychological characteristics, assessing patients’ psychological status may be important. Awareness of fatigue could be incorporated into dietary interventions for older adults with diabetes.

Highlights

South Korea is experiencing rapid growth in the aging population
Using the dynamic biopsychosocial (DBPS) model, the current study examined the influences of physical, psychological, interpersonal, and contextual factors on fatigue in a sample of community-dwelling older adults with diabetes
We found that almost half of the older adults with diabetes experienced moderate or severe fatigue, indicating susceptibility to fatigue in this population

Summary

Introduction

South Korea is experiencing rapid growth in the aging population. In 2018, residents aged 65 years and older represented 14.3% of the total population, and the aging population will rise to be over 21%of the total population over the decade [1]. In Korea, the prevalence of diabetes among older adults was reported to be 28.3% in 2018, which is expected to speed up with the rapid growth of the aging population [3,4]. Diabetes in older adults is unique and different from the presentation of diabetes in other age groups, as it is simultaneously influenced by both the degenerative aging process and abnormal glucose metabolism [5,6,7]. Both aging and diabetes independently increase an individual’s risk of impairment in their functional abilities in daily living and psychological well-being [7,8]. Having diabetes is a stressful life event that increases the burdens for older adults owing to the daily therapeutic regimen

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