AUTHOR=Shi Jing , Tao Yongkang , Wang Lixiang , Chen Shuqiang , Zhou Ziyi , Meng Li , Zhou Baiyu , Duan Chunbo , Xi Huan , Yu Pulin 

TITLE=Combined effect of diabetes and frailty on mortality among Chinese older adults: A follow-up study

JOURNAL=Frontiers in Endocrinology

VOLUME=13

YEAR=2023

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.1105957

DOI=10.3389/fendo.2022.1105957

ISSN=1664-2392

ABSTRACT=<sec><title>Background</title><p>Frailty and diabetes are two important health problems associated with aging in older individuals. This paper seeks to analyze the frailty in older adults suffering from diabetes and the combined effect of diabetes and frailty on mortality risk.</p></sec><sec><title>Methods</title><p>The frailty index (FI) model was employed when evaluating frailty among the older adults based on the baseline data conducted in 2009; and death as outcome variables collected in 2020 were analyzed. The influence of diabetes on age-related changes in frailty in the older adults and resulting mortality rates was analyzed. Cox regression and Kaplan-Meier curves were applied to evaluate the influence on the risk of death and the 11-year survival of the older adults with varying diabetes and frailty statuses.</p></sec><sec><title>Results</title><p>Ultimately, 1,213 older people aged between 60 and 101, with an average age of (74.79 ± 8.58) at baseline, were included in the analysis. By 2020, there had been 447 deaths with mortality at 36.9% (447/1,213); there were 271 cases of diabetes, with a prevalence of 22.3% (271/1,213). The mean FI value for older adults with diabetes was higher than that of those without regardless of age, and the average annual relative growth rate of the FI value for older adults with diabetes was higher than that of those without diabetes (<italic>β =</italic> 0.039 <italic>vs. β =</italic> 0.035<italic>, t =</italic> 8.367, <italic>P &lt;</italic> 0.001). For all FI value levels, the mortality rate among older adults with diabetes was higher than that of those without. The Cox Regression analysis showed that, compared with those suffering from neither diabetes nor frailty, older adults with both had the higher mortality risk (<italic>HR</italic> = 1.760. P <italic>&lt;</italic> 0.001), followed by older adults suffering from frailty alone (<italic>HR</italic> = 1.594, <italic>P</italic> = 0.006), and then by older adults suffering from only diabetes (<italic>HR</italic> = 1.475, <italic>P</italic> = 0.033). The survival analysis showed that the median survival of those suffering from diabetes and frailty to be the shortest at just 57.23 (95% <italic>CI</italic>: 54.05 to 60.41) months, lower than the 83.78 (95% <italic>CI</italic>: 79.33 to 88.23) months in those suffering from frailty alone, and 119.93 (95% <italic>CI</italic>: 113.84 to 126.02) months in those with only diabetes, and 124.39 (95% <italic>CI</italic>: 119.76 to 129.02) months in older adults with neither diabetes nor frailty (<italic>P &lt;</italic> 0.001).</p></sec><sec><title>Conclusion</title><p>Frailty is common among older adults suffering from diabetes, and there is an increased risk of poor health outcomes, such as death, among older adults suffering from diabetes and frailty. When diagnosing, treating, and dealing with older adults with diabetes, attention should be paid to screening and assessing frailty in hopes of identifying it early so that appropriate measures of intervention can be taken to avoid or delay the resulting adverse effects.</p></sec>