Ying Li1, Yupei Zou1, Shuang Wang2, Jun Li1, Xiaofan Jing3, Mengxuan Yang4, Lingxiao Wang1, Li Cao1, Xue Yang1, Ling Xu1, Birong Dong1. 1. The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Sichuan, China. 2. The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Sichuan, China. Electronic address: wangs0211@hotmail.com. 3. Department of Clinical Nutrition, West China Hospital, Sichuan University, Sichuan, China. 4. Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Sichuan, China.
Abstract
OBJECTIVE: To determine the prevalence of frailty in older diabetic inpatients using the FRAIL scale and to evaluate the association of frailty with physical function and diabetic vascular complications, as well as its relationship to hospitalization and mortality. METHODS: This pilot study was conducted at the Center of Gerontology and Geriatrics, West China Hospital. A total of 146 inpatients aged 60 years or older with type 2 diabetes were enrolled between December 2011 and October 2012, and participants were followed until December 2013. Frailty, functional status, diabetic nephropathy, and macroangiopathy were assessed at enrollment. The longitudinal outcomes were hospitalization and mortality. Frailty was determined by the 5-item FRAIL scale. Functional status was determined using activities of daily living (ADLs), instrumental activities of daily living (IADLs), and timed "Up and Go" test (TUG). RESULTS: At baseline, 47.2% of participants were robust, 37.7% were prefrail, and 15.1% were frail. After adjusting for age, gender, MMSE score, body mass index (BMI), and the duration and severity of diabetes, both prefrailty and frailty were significantly associated with ADL disability (odds ratio [OR] 2.84 and 6.58, respectively), mobility impairment (OR 3.89 and 22.15, respectively), and diabetic nephropathy (OR 4.31 and 4.46, respectively). In the year after enrollment, the proportion of participants with 3 or more hospitalizations was 16.0% among robust participants, 23.6% among prefrail participants, and 40.9% among frail participants. Being frail predicted a greater number of hospitalizations (OR 5.99). There was no cumulative mortality for robust participants, whereas 3.6% of prefrail participants and 22.7% of frail participants died during follow-up (P < .001). CONCLUSION: In older diabetic inpatients in China, frailty is an independent risk factor for adverse health outcomes. Clinicians could use the FRAIL scale to regularly identify individuals who are frail or who are at risk of becoming frail.
OBJECTIVE: To determine the prevalence of frailty in older diabetic inpatients using the FRAIL scale and to evaluate the association of frailty with physical function and diabetic vascular complications, as well as its relationship to hospitalization and mortality. METHODS: This pilot study was conducted at the Center of Gerontology and Geriatrics, West China Hospital. A total of 146 inpatients aged 60 years or older with type 2 diabetes were enrolled between December 2011 and October 2012, and participants were followed until December 2013. Frailty, functional status, diabetic nephropathy, and macroangiopathy were assessed at enrollment. The longitudinal outcomes were hospitalization and mortality. Frailty was determined by the 5-item FRAIL scale. Functional status was determined using activities of daily living (ADLs), instrumental activities of daily living (IADLs), and timed "Up and Go" test (TUG). RESULTS: At baseline, 47.2% of participants were robust, 37.7% were prefrail, and 15.1% were frail. After adjusting for age, gender, MMSE score, body mass index (BMI), and the duration and severity of diabetes, both prefrailty and frailty were significantly associated with ADL disability (odds ratio [OR] 2.84 and 6.58, respectively), mobility impairment (OR 3.89 and 22.15, respectively), and diabetic nephropathy (OR 4.31 and 4.46, respectively). In the year after enrollment, the proportion of participants with 3 or more hospitalizations was 16.0% among robust participants, 23.6% among prefrail participants, and 40.9% among frail participants. Being frail predicted a greater number of hospitalizations (OR 5.99). There was no cumulative mortality for robust participants, whereas 3.6% of prefrail participants and 22.7% of frail participants died during follow-up (P < .001). CONCLUSION: In older diabetic inpatients in China, frailty is an independent risk factor for adverse health outcomes. Clinicians could use the FRAIL scale to regularly identify individuals who are frail or who are at risk of becoming frail.
Authors: Josep Franch-Nadal; Fermín García-Gollarte; Alfonso Pérez Del Molino; María L Orera-Peña; Marta Rodríguez de Miguel; Malena Melogno-Klinkas; Héctor D de Paz; Susana Aceituno; Patricia Rodríguez-Fortúnez Journal: Clin Drug Investig Date: 2019-01 Impact factor: 2.859
Authors: Hongjiang Wu; Eric S H Lau; Aimin Yang; Ronald C W Ma; Alice P S Kong; Elaine Chow; Wing-Yee So; Juliana C N Chan; Andrea O Y Luk Journal: Cardiovasc Diabetol Date: 2020-05-12 Impact factor: 9.951