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Frailty, diabetes, and the convergence of chronic disease in an age-related condition: a population-based nationwide cross-sectional analysis of the Mexican nutrition and health survey

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Abstract

Aims

To describe the associations of frailty with diabetes mellitus and related conditions in older adults.

Methods

We conducted a cross-sectional analysis of a representative sample of older adults (n = 5379). We generated a 35-item frailty index (FI) and obtained information on diabetes and related conditions (peripheral neuropathy, lower limb amputation, diabetic coma, number of physician visits due to diabetes-related conditions, all-cause hospitalizations in the past year, years since diabetes diagnosis, and type of treatment). Logistic and Poisson regression models were used to determine the associations between frailty and diabetes and its complications.

Results

The mean age was 70.3 years (± 7.8); 54.7% were women. Those with an FI ≤ 0.082 composed the reference group. Multivariate analysis showed an OR of 2.32 (95% CI 1.93–2.73, p < 0.001) for the association between diabetes and frailty. People who were hospitalized for any cause during the previous year, those receiving both insulin and an oral compound to manage diabetes, and those with peripheral neuropathy showed ORs of 2.32 (95% CI 1.69–3.18, p < 0.001), 5.6 (95% CI 1.58–19.8, p = 0.008), and 2.02 (95% CI 1.42–2.86, p < 0.001), respectively, for being in the most frail group.

Conclusions

People with diabetes have higher frailty scores. Furthermore, older adults with diabetes and higher burden of frailty have more diabetes-related complications.

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Abbreviations

FI:

Frailty index

ENSANUT:

Encuesta Nacional de Salud y Nutrición

SD:

Standard deviation

IQR:

Interquartile range

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Author information

Authors and Affiliations

  1. Geriatric Epidemiology Research Department, National Institute of Geriatrics, Periférico Sur 2767, Colonia San Jerónimo Lídice, Delegación Magdalena Contreras, C.P. 10200, Mexico City, Mexico

    Roberto C. Castrejón-Pérez, Luis M. Gutiérrez-Robledo & Mario U. Pérez-Zepeda

  2. Diabetes Clinic, Endocrinology Department, Nutritional and Medical Sciences Institute “Salvador Zubirán”, Avenida Vasco de Quiroga No.15, Colonia Belisario Domínguez Sección XVI, Delegación Tlalpan, Mexico City, C.P.14080, Mexico

    Carlos A. Aguilar-Salinas

  3. Geriatric Unit, Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Milan, Italy

    Matteo Cesari

  4. Department of Medical Sciences and Community Health, University of Milan, Milan, Italy

    Matteo Cesari

Authors
  1. Roberto C. Castrejón-Pérez
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  2. Carlos A. Aguilar-Salinas
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  3. Luis M. Gutiérrez-Robledo
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  4. Matteo Cesari
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  5. Mario U. Pérez-Zepeda
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Contributions

R.C.C.P. contributed to the conception, design, and drafting of the work. C.A.A.S. contributed to the analysis, design, and final draft. L.M.G.R. contributed to the conception and critical revision of the work. M.C. contributed to the design and conception of the original research question and the drafting and critical revision of the manuscript. M.U.P.Z. contributed to the conception, design, analysis, interpretation, and drafting of the work.

Corresponding author

Correspondence to Mario U. Pérez-Zepeda.

Ethics declarations

Ethical approval

The research and ethics committee of the National Institute of Public Health (México) approved this study, and it was registered at the National Institute of Geriatrics (México DI-PI-008/15).

Informed consent

ll subjects signed an informed consent form.

Funding

This work was partially supported by the Instituto Nacional de Geriatría, grant number DI-C2016-MC-001.

Conflict of interest

All authors declare that they have no conflict of interest.

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Castrejón-Pérez, R.C., Aguilar-Salinas, C.A., Gutiérrez-Robledo, L.M. et al. Frailty, diabetes, and the convergence of chronic disease in an age-related condition: a population-based nationwide cross-sectional analysis of the Mexican nutrition and health survey. Aging Clin Exp Res 30, 935–941 (2018). https://doi.org/10.1007/s40520-017-0852-2

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  • DOI: https://doi.org/10.1007/s40520-017-0852-2

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