Cognitive Frailty in Older People with Type 2 Diabetes Mellitus: the Central Role of Hypoglycaemia and the Need for Prevention

  • A. H. AbdelhafizEmail author
  • A. J. Sinclair
Other Forms of Diabetes and Its Complications (JJ Nolan and H Thabit, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Other Forms of Diabetes and Its Complications


Purpose of Review

To highlight the central role of hypoglycaemia in the causation of cognitive frailty and explore ways of recognition and prevention of hypoglycaemia.

Recent Findings

Cognitive frailty is an emerging new concept defined as the concomitant presence of physical frailty and cognitive impairment. In older people with diabetes, cognitive frailty is associated with an increased risk of mortality greater than from either physical frailty or cognitive impairment alone. Hypoglycaemia is directly associated with increased risk of cognitive impairment and physical frailty which are the two components of cognitive frailty. The incidence of hypoglycaemia in older people with diabetes is rising and hypoglycaemia-related hospitalisation has overtaken that of hyperglycaemia.


Recognition of hypoglycaemic episodes in old age remains challenging which leads to misdiagnoses and under-reporting. Therefore, hypoglycaemia prevention strategies are needed. Research is still required to investigate whether prevention of hypoglycaemia would lead to a reduction in the incidence of cognitive frailty.


Cognition Frailty Hypoglycaemia Older people Diabetes mellitus 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Geriatric MedicineRotherham General HospitalRotherhamUK
  2. 2.Foundation for Diabetes Research in Older PeopleDiabetes Frail LtdDroitwich SpaUK
  3. 3.Kings CollegeLondonUK

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