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Frailty, diabetes, and mortality in middle-aged African Americans

  • Published:
The journal of nutrition, health & aging

Abstract

Background

Older adult frail diabetics have high mortality risk, but data are limited regarding frail late middle-aged diabetics, especially for African-Americans. The aim of this study is to examine the association of diabetes with health outcomes and frailty in the African American Health (AAH) study.

Methods

AAH is a population-based longitudinal cohort study. Participants were African Americans (N=998) ages 49 to 65 years at baseline. Cross-sectional comparisons for diabetes included disability, function, physical performance, cytokines, and frailty. Frailty measures included the International Academy of Nutrition and Aging [FRAIL] frailty scale, Study of Osteoporotic Fractures [SOF] frailty scale, Cardiovascular Health Study [CHS] frailty scale, and Frailty Index [FI]). Longitudinal associations for diabetes included new ADLs ≥ 1 and mortality at 9-year follow-up.

Results

Diabetics were more likely to be frail using any of the 4 frailty scales than were non-diabetics. Frail diabetics, compared to nonfrail diabetics, reported significantly increased falls in last 1 year, higher IADLs and higher LBFLs. They demonstrated worse performance on the SPPB, one-leg stand, and grip strength; and higher Tumor Necrosis Factor receptors (sTNFR1 & sTNFR2). Mortality and 1 or more new ADLs also were increased among frail compared to nonfrail diabetics when followed for 9 years.

Conclusions

Frailty in middle-aged African American persons with diabetes is associated with having more disability and functional limitations, worse physical performance, and higher cytokines (sTNFR1 & sTNFR2 only). Middle-aged African Americans with diabetes have an increased risk of mortality and frail diabetics have an even higher risk of death, compared to nonfrail diabetics.

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Author information

Authors and Affiliations

  1. Division of Endocrinology, Department of Internal Medicine, School of Medicine, Saint Louis University, St. Louis, MO, USA

    S. Chode & John E. Morley

  2. Department of Psychiatry and Behavioral Neuroscience, School of Medicine, Saint Louis University, St. Louis, MO, USA

    T. K. Malmstrom

  3. Division of Geriatrics, Department of Internal Medicine, School of Medicine, Saint Louis University, St. Louis, MO, USA

    T. K. Malmstrom & John E. Morley

  4. Regenstrief Institute, Inc., and IU Center for Aging, Indianapolis, IN, USA

    D. K. Miller

Authors
  1. S. Chode
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  2. T. K. Malmstrom
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  3. D. K. Miller
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  4. John E. Morley
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Correspondence to John E. Morley.

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Chode, S., Malmstrom, T.K., Miller, D.K. et al. Frailty, diabetes, and mortality in middle-aged African Americans. J Nutr Health Aging 20, 854–859 (2016). https://doi.org/10.1007/s12603-016-0801-3

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  • DOI: https://doi.org/10.1007/s12603-016-0801-3

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