Nicola Veronese1, Brendon Stubbs2, Luigi Fontana3, Caterina Trevisan4, Francesco Bolzetta4, Marina De Rui4, Leonardo Sartori5, Estella Musacchio5, Sabina Zambon6, Stefania Maggi7, Egle Perissinotto8, Maria Chiara Corti9, Gaetano Crepaldi7, Enzo Manzato10, Giuseppe Sergi4. 1. Geriatrics Division, Department of Medicine-DIMED, University of Padova, Italy; Institute of clinical Research and Education in Medicine (IREM), Padova, Italy. Electronic address: ilmannato@gmail.com. 2. Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom. 3. Department of Clinical and Experimental Sciences, Brescia University, Italy; Department of Medicine, Washington University School of Medicine, St Louis, MO, USA; CEINGE Biotecnologie Avanzate, Napoli, Italy. 4. Geriatrics Division, Department of Medicine-DIMED, University of Padova, Italy. 5. Clinica Medica I, Department of Medicine-DIMED, University of Padova, Italy. 6. Department of Medicine, Washington University School of Medicine, St Louis, MO, USA; Neuroscience Institute, National Research Council, Padova, Italy. 7. Neuroscience Institute, National Research Council, Padova, Italy. 8. Biostatistics, Epidemiology and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy. 9. Division of Health Care Planning and Evaluation of the Regione Veneto, Venice, Italy. 10. Geriatrics Division, Department of Medicine-DIMED, University of Padova, Italy; Neuroscience Institute, National Research Council, Padova, Italy.
Abstract
OBJECTIVE: To investigate whether frailty is associated with an increased risk of incident type 2 diabetes mellitus (T2DM) in a prospective cohort of community-dwelling older people. DESIGN: Longitudinal study, mean follow-up of 4.4 years. SETTING: Progetto Veneto Anziani (Pro.V.A.) study that involved older community-dwellers. PARTICIPANTS: 1754 men and women older than 65 years without T2DM at baseline. MEASUREMENTS: Frailty status was defined according to Fried criteria and categorized as frailty (≥3 criteria), prefrailty (1-2 criteria), or no frailty (0 criterion). Incident T2DM was defined as fasting plasma glucose (FPG) ≥7.0 mmol/L, or glycosylated hemoglobin ≥6.5%, the use of glucose-lowering drugs, or FPG ≥11.1 mmol/L on a 2-hour oral glucose tolerance test during the follow-up. All T2DM diagnoses were confirmed by endocrinologists. RESULTS: At baseline, frail participants (n = 174) were significantly (a) more obese and had higher waist circumference, (b) experienced a higher rate of cardiovascular disease (including hypertension), and (c) presented with higher, but not pathologic, values of glycosylated hemoglobin and FPG than prefrail (n = 830) and nonfrail participants (n = 750). Over a 4.4-year follow-up, 265 individuals developed T2DM. In a logistic regression analysis, adjusted for potential baseline confounders, frailty [odds ratio (OR) = 1.87, 95% confidence interval (CI) = 1.31-2.13, P < .0001] and prefrailty (OR = 1.60, 95% CI = 1.27-2.00, P < .0001) were associated with a significantly higher incidence of T2DM than in nonfrail individuals. CONCLUSION: Among community-dwelling older people, frailty and prefrailty were significant and independent predictors of T2DM, which is a major and potentially preventable risk factor for multiple comorbidities.
OBJECTIVE: To investigate whether frailty is associated with an increased risk of incident type 2 diabetes mellitus (T2DM) in a prospective cohort of community-dwelling older people. DESIGN: Longitudinal study, mean follow-up of 4.4 years. SETTING: Progetto Veneto Anziani (Pro.V.A.) study that involved older community-dwellers. PARTICIPANTS: 1754 men and women older than 65 years without T2DM at baseline. MEASUREMENTS: Frailty status was defined according to Fried criteria and categorized as frailty (≥3 criteria), prefrailty (1-2 criteria), or no frailty (0 criterion). Incident T2DM was defined as fasting plasma glucose (FPG) ≥7.0 mmol/L, or glycosylated hemoglobin ≥6.5%, the use of glucose-lowering drugs, or FPG ≥11.1 mmol/L on a 2-hour oral glucose tolerance test during the follow-up. All T2DM diagnoses were confirmed by endocrinologists. RESULTS: At baseline, frail participants (n = 174) were significantly (a) more obese and had higher waist circumference, (b) experienced a higher rate of cardiovascular disease (including hypertension), and (c) presented with higher, but not pathologic, values of glycosylated hemoglobin and FPG than prefrail (n = 830) and nonfrail participants (n = 750). Over a 4.4-year follow-up, 265 individuals developed T2DM. In a logistic regression analysis, adjusted for potential baseline confounders, frailty [odds ratio (OR) = 1.87, 95% confidence interval (CI) = 1.31-2.13, P < .0001] and prefrailty (OR = 1.60, 95% CI = 1.27-2.00, P < .0001) were associated with a significantly higher incidence of T2DM than in nonfrail individuals. CONCLUSION: Among community-dwelling older people, frailty and prefrailty were significant and independent predictors of T2DM, which is a major and potentially preventable risk factor for multiple comorbidities.
Authors: Nicola Veronese; Brendon Stubbs; Marianna Noale; Marco Solmi; Alberto Pilotto; Alberto Vaona; Jacopo Demurtas; Christoph Mueller; Jonathan Huntley; Gaetano Crepaldi; Stefania Maggi Journal: J Am Med Dir Assoc Date: 2017-04-07 Impact factor: 4.669