Araki Atsushi, Ito Hideki
Department of Endocrinology, Tokyo Metropolitan Geriatric Hospital, Sakae-cho, Tokyo, Japan.
Geriatr Gerontol Int. 2009 Jun;9(2):105-14. doi: 10.1111/j.1447-0594.2008.00495.x.
Diabetes mellitus is associated with an increased prevalence and incidence of geriatric syndrome: functional disabilities, depression, fall, urinary incontinence, malnutrition and cognitive impairment. Geriatric syndrome not only leads to frailty, loss of independence and low quality of life, but also becomes a major obstacle in the treatment and care of diabetic people. The risk factors or contributing factors of geriatric symptoms are micro- and macrovascular complications, age-rated comorbid disease and aging per se. Comprehensive geriatric assessment of geriatric syndrome, including basic activities of daily living, instrumental activities of daily living, gait and balance, visual acuity, the Mini-Mental State Examination, depression scores, history and risk of fall, urination and nutrition, should be performed as part of the care of elderly diabetic patients, in particular old-old patients. Because geriatric syndromes are multifactorial and share risk factors, diabetic people with any geriatric symptoms should be treated with a common concentric strategy, such as supervised exercise therapy including muscle-strengthening training, psychological support, social support for adherence, and good glycemic control with avoidance of hypoglycemia.
糖尿病与老年综合征的患病率和发病率增加相关，这些综合征包括功能残疾、抑郁、跌倒、尿失禁、营养不良和认知障碍。老年综合征不仅会导致身体虚弱、失去独立生活能力和生活质量低下，还成为糖尿病患者治疗和护理的主要障碍。老年症状的危险因素或促成因素包括微血管和大血管并发症、与年龄相关的合并症以及衰老本身。作为老年糖尿病患者，尤其是高龄患者护理的一部分，应进行老年综合征的综合评估，包括基本日常生活活动、工具性日常生活活动、步态和平衡、视力、简易精神状态检查、抑郁评分、跌倒史和风险、排尿和营养状况。由于老年综合征是多因素的且有共同的危险因素，患有任何老年症状的糖尿病患者都应采用共同的同心策略进行治疗，如包括肌肉强化训练的监督运动疗法、心理支持、对坚持治疗的社会支持以及避免低血糖的良好血糖控制。
