Frailty Prevalence and Characteristics in Older Patients with Type 2 Diabetes

Takahisa Tanikawa,Hidenori Arai,Sayuri Sable-Morita,Haruhiko Tokuda

doi:10.4236/jdm.2019.92004

Abstract

Background: Older diabetic patients are more likely to be frail than those who do not have diabetes. Frailty is an important risk factor for both mortality and disability in older patients with type 2 diabetes. However, the mechanism of frailty in diabetes mellitus is not fully understood. Aims: The aim of this study was to identify the prevalence of frailty and associated factors in older patients with type 2 diabetes in Japan. Methods: A cross-sectional study was conducted with a total of 178 outpatients who were over 65 years old with type 2 diabetes. We used the Obu Study Health Promotion for the Elderly definition of frailty to divided subjects into a non-frail and a frail group. We investigated the association between frailty and various patient characteristics. Results: In the study, 21.4% of the older patients with type 2 diabetes were considered frail. There were no significant differences in the duration of diabetes, BMI, proportion of microvascular complications, or HbA1c values between the frail and non-frail group. However, serum albumin and IGF-1 levels were lower in the frail group than the non-frail group as were the Mini-Mental State Examination scores. The frail group had a higher number of medications than the non-frail group. In a multivariable analysis, frailty was positively associated with the number of medications and, lower levels of both serum albumin and IGF-1. Conclusion: Our study suggests that diabetes accelerates the aging process and frailty is associated with low albumin, polypharmacy and low levels of IGF-1.

Highlights

The prevalence of type 2 diabetes is increasing in the older population of Japan with patients over 65 years of age accounting for 40% or more of all diabetes patients [1]
Our study suggests that diabetes accelerates the aging process and frailty is associated with low albumin, polypharmacy and low levels of IGF-1
The median age and number of medications were higher in the frail group, while the median levels of serum albumin, growth hormone (GH) and IGF-1 were lower in the frail group than those in the non-frail group

Summary

Introduction

The prevalence of type 2 diabetes is increasing in the older population of Japan with patients over 65 years of age accounting for 40% or more of all diabetes patients [1]. Frailty is a state of increased vulnerability to stressors with reduced ability to maintain homeostasis This condition is highly prevalent in old age and increases the risk of adverse outcomes, including falls, disability, hospitalization, and mortality [2] [3]. Frailty is an important risk factor for both mortality and disability in older patients with type 2 diabetes. Aims: The aim of this study was to identify the prevalence of frailty and associated factors in older patients with type 2 diabetes in Japan. Frailty was positively associated with the number of medications and, lower levels of both serum albumin and IGF-1. Conclusion: Our study suggests that diabetes accelerates the aging process and frailty is associated with low albumin, polypharmacy and low levels of IGF-1

Objectives

Methods

Results

Conclusion