Abstract
BackgroundVarious factors including cardio-metabolic disorders are found to be correlated with frailty. With the increase in age, older adults are likely to have elevated blood glucose level. In this study we intend to investigate the prevalence and incidence of frailty in the pre-diabetic and diabetic community dwelling elderly population and the associated risk factors.MethodsAt baseline total of 10,039 subjects with a mean age of 70.51 (±7.82) were included. A total of 6,293 older adults were followed up at 12 months. A Frailty index (FI) with 32 items was developed using Rockwood’s cumulative deficits method. Frailty index ≥0.25 was used as cut-off criteria for the diagnosis of frailty. Diagnosis of pre-diabetes and diabetes was set according to the World Health Organization (WHO) criteria for fasting plasma glucose (FPG) level. Chi-square tests were performed to compare percentages by 3 major groups (non-diabetes, pre-diabetes, diabetes), ANOVA and student’s t-tests was used to compare means of group for continuous variables. Multiple logistic regression models were performed to estimate the risk factors for frailty in non-diabetic, pre-diabetic and diabetic elderly populations using baseline and longitudinal data.ResultsDiabetic population had a much higher prevalence (19.32%) and incidence (12.32%) of frailty, compared to that of non-diabetic older adults (prevalence of 11.92% and incidence of 7.04%). And pre-diabetics had somewhat similar prevalence of 11.43% and slightly higher incidence of 8.73% for frailty than non-diabetic older adults. Diabetics were at 1.36 (95% CI = 1.18,1.56) and 1.56 (95%CI = 1.32,1.85) fold increase in risk of frailty compared to non-diabetic population for prevalence and incidence, respectively. Being female, urban living, high waist circumference, less house work and need regular anti-diabetic medications were independent risk factors only in pre-diabetic and diabetic older adults.ConclusionThis study confirms that diabetes is an independent serious chronic condition to increase the risk of frailty in community dwelling older adults in northern China. To effectively delay or avoid frailty, older adults should be advised for taking proper control of blood glucose level and avoiding the associated risk factors and implementing the protective factors in primary-care setting.
Highlights
Various factors including cardio-metabolic disorders are found to be correlated with frailty
Previous studies have shown that older diabetic adults are at higher risk of being frail [6,7,8], these study did not examine the risks for frailty in other elevated blood glucose older population
Crude and adjusted risks of frailty comparing pre-diabetic and diabetic subjects with those with normal blood glucose at baseline and follow-up survey Using both unadjusted and adjusted logistic regression, we found having diabetes increased the risk of prevalence frailty at baseline (Additional file 2: Table S2 Appendix 2), the crude and adjusted OR were 1.77 (95%CI = 1.56–2.00, P < .0001), and 1.36 (95%CI = 1.18–1.56, P < .0001), controlling for age, sex, residency and co-morbidity
Summary
In this study we intend to investigate the prevalence and incidence of frailty in the pre-diabetic and diabetic community dwelling elderly population and the associated risk factors. Various factors including cardio-metabolic disorders are found to be correlated with frailty, among which diabetes in the elderly population cannot be excluded. With the increase in age, older adults are likely to have alteration in glucose metabolism which may be due to decrease in insulin sensitivity and resistance, islet cell dysfunction or reduced beta-cell sensitivity leading to elevated glucose level [3]. We intend to investigate the prevalence and incidence of frailty in community dwelling subjects more than 55 years old with elevated blood glucose (pre-diabetes, diabetes), and if these population shared the common risk factors as normal blood glucose frail population
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
