Study of frailty index in elderly men with type 2 diabetes mellitus

Abstract

Introduction Frailty is a common and growing multidimensional health and social care challenge across the world. Diabetes mellitus (DM) is one of the most important causes of morbidity and mortality in Egypt. Frailty and diabetes are inter-related. In addition, diabetes causes early-onset frailty. In this study we aimed to determine the frailty index in elderly men with type 2 DM and compare it with that in pre-elderly diabetic patients and age-matched healthy controls. Materials and methods Seventy male participants were included in the present study and were divided into three groups. Group I comprised 20 healthy men aged 65-75 years who were considered the control group; group II comprised 25 patients aged 50-64 years with type 2 DM; and group III comprised 25 patients aged 65-75 years with type 2 DM. Patients on insulin therapy and those with hypogonadism or hypothyroidism were excluded from the study. Frailty index was determined for all participants using Fried′s five phenotypic parameters. Patients were considered frail if they fulfilled more than or equal to three parameters, prefrail if they fulfilled one to two parameters, and nonfrail if they fulfilled none of the parameters. Data were collected, analyzed, and compared between groups I and III and between groups II and III. Further, frailty index was correlated with the duration of DM and the degree of glycemic control. Results Seventy patients were divided into three groups. The mean age in group I was 68.50 ± 1.90 years, that in group II was 58.24 ± 4.34 years, and that in group III was 68.60 ± 2.43 years. Regarding the frailty index, in group I 17 patients (85%) were nonfrail, three (15%) were prefrail, and none were frail; in group II, four patients (16%) were prefrail, 21 (84%) were frail, and none were nonfrail; and in group III, three patients (12%) were prefrail, 22 (88%) were frail, and none were nonfrail. A statistically significant difference was noted between groups I and III, whereas no significant difference was noted between groups II and III. A significant positive correlation was found between the frailty index score and duration of diabetes and degree of glycemic control in groups II and III. Conclusion Diabetes and frailty are causally related. Diabetes is associated with frailty at earlier age. The duration of diabetes and degree of glycemic control correlate with the severity of frailty in both elderly and pre-elderly diabetic patients.