The frailty syndrome in older adults with type 2 diabetes mellitus and associated factors

Abstract Objective: To compare clinical-functional factors among groups in relation to the frailty syndrome (pre-frail and frail) phenotype profile in older adults with type 2 diabetes mellitus (DM 2). Methods: A descriptive, analytical, cross-sectional study with a quantitative approach was performed. A total of 113 diabetic older adults of both sexes were evaluated in terms of their personal, socio-demographic, clinical-functional, mental, cognitive and fragility phenotype data. The Chi-square test and a logistic regression model were used. Results: The mean age was 68.66±6.62 years, and the sample was mostly female (61.9%), illiterate or with an incomplete primary education (60.2%), pre-frail (52.2%), sedentary (79.6%), and had been diagnosed with DM2 for more than 5 years (58.3%). There was a significant association between “pre-frail and frail” individuals and schooling (p=0.004), social participation (p=0.004), a subjective perception of vision (p=0.004), glycated hemoglobin (p=0.036), limb pain (p=0.012), depressive symptoms (p=0.002) and mobility (p=0.004). The logistic regression model showed an accuracy of 93.6% and the significant variables were education (p=0.039), pain in the lower limbs (p=0.025) and risk of falls (p=0.033). Conclusion: among all the factors related to the “pre-frail” and “frail” phenotype, schooling, pain in the lower limbs and mobility were most related to the worsening of the syndrome and its progress.

摘要 目的：本研究旨在比较2型糖尿病（type 2 diabetes mellitus, DM2）老年患者中，不同衰弱综合征（frailty syndrome）表型组（衰弱前期（pre-frail）、衰弱期（frail））间的临床功能相关因素差异。方法：本研究采用定量研究方法，开展描述性分析横断面研究（cross-sectional study）。共纳入113名男女老年糖尿病患者，对其个人信息、社会人口学特征、临床功能状态、精神心理状况、认知水平及衰弱表型数据进行采集与评估，统计分析采用卡方检验（Chi-square test）与逻辑回归模型（logistic regression model）。结果：研究对象平均年龄为68.66±6.62岁，其中女性占比61.9%，文盲或小学教育未完成者占60.2%，处于衰弱前期者占52.2%，久坐不动者占79.6%，确诊DM2病程超过5年者占58.3%。衰弱前期与衰弱期人群的受教育程度、社会参与度、主观视力状况、糖化血红蛋白（glycated hemoglobin）水平、肢体疼痛情况、抑郁症状（depressive symptoms）及活动能力（mobility）均存在显著统计学关联（p值分别为0.004、0.004、0.004、0.036、0.012、0.002、0.004）。本次构建的逻辑回归模型预测准确率达93.6%，其中具有独立统计学意义的影响因素为受教育程度（p=0.039）、下肢疼痛（p=0.025）及跌倒风险（risk of falls，p=0.033）。结论：在与衰弱前期及衰弱期表型相关的所有影响因素中，受教育程度、下肢疼痛与活动能力与衰弱综合征的病情加重及进展最为密切相关。