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

  • Other Forms of Diabetes and Its Complications (JJ Nolan and H Thabit, Section Editors)
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Abstract

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.

Summary

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.

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Authors and Affiliations

  1. Department of Geriatric Medicine, Rotherham General Hospital, Moorgate Road, Rotherham, S60 2UD, UK

    A. H. Abdelhafiz

  2. Foundation for Diabetes Research in Older People, Diabetes Frail Ltd, Droitwich Spa, WR9 0QH, UK

    A. J. Sinclair

  3. Kings College, London, SE1 9NH, UK

    A. J. Sinclair

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  1. A. H. Abdelhafiz
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Correspondence to A. H. Abdelhafiz.

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Key Points

• Cognitive frailty is a new concept that describes the co-existence of physical frailty and cognitive impairment.

• Cognitive frailty is associated with adverse outcomes in older people with diabetes.

• Hypoglycaemia may play a central role in the development of cognitive frailty in older people with diabetes.

• Hypoglycaemia incidence is increasing and its recognition remains challenging to health care professionals.

• Prevention strategies for hypoglycaemia are needed.

This article is part of the Topical Collection on Other Forms of Diabetes and Its Complications

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Abdelhafiz, A.H., Sinclair, A.J. Cognitive Frailty in Older People with Type 2 Diabetes Mellitus: the Central Role of Hypoglycaemia and the Need for Prevention. Curr Diab Rep 19, 15 (2019). https://doi.org/10.1007/s11892-019-1135-4

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