Table 2.
Recent studies exploring risk of frailty in older people with diabetes
| Study | Patients | Aim to | Main findings |
|---|---|---|---|
| Castrejón-Pérez et al. cross sectional, Mexico, 2017. [22] | 7164 Mexican subjects, mean (SD) age 70.6 (8.1) Y | Explore association of DM, hypertension and frailty | Independent association with frailty of: |
| A. DM, hypertension or both (coefficients 0.28, 0.4 and 0.63, respectively, p < 0.001) | |||
| B. Any diabetic complications, duration of DM or diabetes related physician visits (0.55, 0.01 and 0.01 respectively, p < 0.01) | |||
| Chhetri et al. prospective, China, 2017. [20] | 10,039 subjects, mean age 70.5Y at base line, 6,293 subjects F/U 12 M | Investigate prevalence and incidence of frailty in subjects with compared to those without DM | A. Subjects with had higher prevalence (19.3% v 11.9%) and incidence (12.3% v 7.0%) of frailty compared to those without DM |
| B. Prevalence risk 1.4 (95% CI 1.2 to 1.6), incidence risk 1.6 (1.3 to 1.9) in subjects with compared to those without DM | |||
| García-Esquinas et al. prospective, Spain, 2015. [43] | 346 subjects with and 1,404 subjects without DM, age ≥ 60 Y, F/U 3.5 Y | Assess the incidence of frailty and possible mechanisms | A. DM increased risk of frailty (OR 2.18, 95% CI 1.42 to 3.37) |
| B. Unhealthy behaviours, obesity, poor glucose control and altered serum lipid profile increased risk of frailty | |||
| C. Diabetes nutritional therapy reduced risk of frailty | |||
| Howrey et al. prospective, US, 2018. [21] | 301 subjects with and 1026 subjects without DM, age ≥ 60 Y, F/U 18 Y | Examine association of DM with odds of frailty in Mexican Americans | A. DM increased risk of frailty (OR 1.47, 95% CI 1.14 to 1.90) |
| B. Other factors such as low level of education, MI, arthritis and hip fracture increased risk of frailty | |||
| Aguilar-Navarro et al. prospective, Mexico, 2015. [44] | Total 5644 participants, mean (SD) age 68.7 (6.9) Y, 11 Y F/U | Describe characteristics and prognosis of subjects classified as frail | Diabetes was significantly more common in frail than in non-frail subjects (23.7% v 9.9%, p < 0.001) |
| Castrejón-Pérez et al. cross sectional, Mexico, 2018. [23] | Total 5379 subjects, mean (SD) age 70.3 (7.8) Y | Describe associations of frailty with diabetes and related conditions in older people | A. Diabetes was associated with frailty (OR 2.32, 95% CI 1.93 to 2.73, p < 0.001) |
|
B. Most frail groups were: 1. Hospitalised in previous year (2.32, 1.69 to 3.18, p < 0.001) | |||
| 2. On insulin and oral therapy (5.6, 1.58 to 19.8, p = 0.008) | |||
| 3. Peripheral neuropathy (2.02, 1.42 to 2.86, p < 0.001) | |||
| Zaslavsky et al. prospective, US, 2016. [45] | Total 1848 subjects aged ≥ 65 Y, F/U 4.8 Y | Explore incidence of frailty | Incidence of frailty 37% in subjects with diabetes, 30.4% in those without diabetes (HR 1.52, 95% CI 1.19 to 1.94) |
| Thein et al. prospective, Singapore, 2018. [46] | Total 2696 patients aged ≥ 55 Y, 11 Y F/U | Investigate prevalence of physical frailty in subjects with compared to those without DM | Diabetes increased the risk of |
| A. Physical frailty (OR 2.24, 95% CI 1.16 to 4.34) | |||
| B. Combined physical frailty and cognitive impairment (2.01, 1.12 to 3.60) |
Y Years, F/U Follow up, M Months, DM Diabetes mellitus, CI Confidence interval, OR Odds ratio, MI Myocardial infarction, SD Standard deviation, HR Hazard ratio