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2 型糖尿病老年患者老年病表型的患病率更高,出现更早。

Higher prevalence and earlier appearance of geriatric phenotypes in old adults with type 2 diabetes mellitus.

机构信息

Second Department of Internal Medicine, Hippokratio University Hospital of Thessaloniki, Aristotle University of Thessaloniki, Constantinoupoleos Str 49, 54642 Thessaloniki, Greece; Department of Geriatric Medicine, University Hospital Center of Nancy, University of Lorraine, CHRU Nancy Brabois, 5 Rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.

Second Department of Internal Medicine, Hippokratio University Hospital of Thessaloniki, Aristotle University of Thessaloniki, Constantinoupoleos Str 49, 54642 Thessaloniki, Greece; Health Center of Diabata, Genimatas General Hospital, Eleftheriou Venizelou Str 5, 54008, Diavata Thessalonikis, Thessaloniki, Greece.

出版信息

Diabetes Res Clin Pract. 2018 Jan;135:206-217. doi: 10.1016/j.diabres.2017.10.026. Epub 2017 Nov 16.

Abstract

AIMS

To compare the prevalence of cognitive dysfunction, depression, lower mobility performance, disability and falls in older community-dwelling individuals with type 2 diabetes mellitus (T2DM) and in controls of similar age.

METHODS

We conducted a cross-sectional study in primary health care settings in 3 semi-urban regions in Greece. Were assessed 403 community-dwelling older persons (age ≥65 years, median: 73), 198 with and 205 without diabetes. Common geriatric syndromes were studied using structured individual interviews and widely-used screening scales. An ensuing secondary analysis per age group was performed.

RESULTS

After adjusting for several confounding factors, the diabetes group presented a 2-fold greater odds of having abnormal scores in Mini Mental State Examination (95%CI: 1.2-3.4, p = 0.006), a 1.5-fold greater odds of abnormal performance in the Clock Drawing Test (95%CI: 1.0-2.4, p = 0.05) and a 2-fold greater odds of slower performance in Timed-Up-And-Go test (95%CI: 1.1-3.4, p = 0.022). In the analysis per age group, impaired cognitive and mobility performances were observed in individuals with diabetes of the younger subgroup (65-74 years), while in the older subgroup (≥75 years), those differences disappeared.

CONCLUSIONS

In a community-dwelling population aged ≥65 years, cognitive and physical fragilisation is more frequent and is observed at an earlier age in individuals with T2DM than in those without.

摘要

目的

比较 2 型糖尿病(T2DM)老年社区居民与年龄相似的对照组认知功能障碍、抑郁、活动能力下降、残疾和跌倒的患病率。

方法

我们在希腊 3 个半城市地区的基层医疗环境中进行了一项横断面研究。评估了 403 名居住在社区的老年人(年龄≥65 岁,中位数:73 岁),其中 198 名患有糖尿病,205 名没有糖尿病。使用结构化个体访谈和广泛使用的筛查量表研究常见老年综合征。按年龄组进行了后续的二次分析。

结果

在调整了几个混杂因素后,糖尿病组在简易精神状态检查(95%CI:1.2-3.4,p=0.006)中异常评分的可能性增加了 2 倍,在画钟测验(95%CI:1.0-2.4,p=0.05)中异常表现的可能性增加了 1.5 倍,在计时起立行走测试(95%CI:1.1-3.4,p=0.022)中表现较慢的可能性增加了 2 倍。在按年龄组进行的分析中,在年龄较小的亚组(65-74 岁)中,糖尿病患者的认知和活动能力受损,而在年龄较大的亚组(≥75 岁)中,这些差异消失。

结论

在年龄≥65 岁的社区居住人群中,T2DM 患者比无糖尿病患者更早出现认知和身体脆弱化,且更为频繁。

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