HRB Clinical Research Facility Cork, Mercy University Hospital, T12 WE28 Cork, Ireland.
College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, H91 TK33 Galway, Ireland.
Int J Environ Res Public Health. 2020 Dec 19;17(24):9535. doi: 10.3390/ijerph17249535.
Frailty in middle-aged and older adults is associated with diabetes-related complications. The impact of and interaction between diabetes and frailty on psychosocial wellbeing and mortality in Ireland for adults aged ≥50 years were assessed using data from the Survey of Health, Ageing and Retirement in Europe. Measures included diabetes status (self-reported), frailty phenotype (≥3/5 criteria), low self-rated health ("fair" or "poor"), depression screening (EURO-D index score ≥4), and low quality of life (QoL) (CASP-12 index score < 35). Among the 970 participants, those with diabetes ( = 87) were more likely to be frail (23% vs. 8%; < 0.001), have low self-rated health (46% vs. 19%; < 0.001), depression (25% vs. 17%; = 0.070), and low QoL (25% vs. 18%, = 0.085). Adjusting for diabetes, age and sex, frailty independently predicted low self-rated health (OR: 9.79 (5.85-16.36)), depression (9.82 (5.93-16.25)), and low QoL (8.52 (5.19-13.97)). Adjusting for frailty, age and sex, diabetes independently predicted low self-rated health (2.70 (1.63-4.47)). The age-sex adjusted mortality hazard ratio was highest for frailty with diabetes (4.67 (1.08-20.15)), followed by frailty without diabetes (2.86 (1.17-6.99)) and being non-frail with diabetes (1.76 (0.59-5.22)). Frailty independently predicts lower self-reported wellbeing and is associated with reduced survival, underpinning its role as an integral part of holistic diabetes care.
中年人及老年人的衰弱与糖尿病相关并发症有关。本研究利用欧洲健康、老龄化和退休调查的数据,评估了爱尔兰≥50 岁成年人中糖尿病和衰弱对社会心理健康和死亡率的影响和相互作用。评估指标包括糖尿病状态(自我报告)、衰弱表型(≥3/5 项标准)、自我健康评估低(“一般”或“差”)、抑郁筛查(EURO-D 指数评分≥4)和生活质量低(CASP-12 指数评分<35)。在 970 名参与者中,患有糖尿病的人(=87)更有可能衰弱(23%比 8%;<0.001)、自我健康评估低(46%比 19%;<0.001)、抑郁(25%比 17%;=0.070)和生活质量低(25%比 18%;=0.085)。在调整了糖尿病、年龄和性别后,衰弱独立预测自我健康评估低(比值比:9.79(5.85-16.36))、抑郁(9.82(5.93-16.25))和生活质量低(8.52(5.19-13.97))。在调整了衰弱、年龄和性别后,糖尿病独立预测自我健康评估低(2.70(1.63-4.47))。年龄和性别调整后的死亡率风险比,糖尿病伴衰弱最高(4.67(1.08-20.15)),其次是无糖尿病衰弱(2.86(1.17-6.99))和无衰弱糖尿病(1.76(0.59-5.22))。衰弱独立预测自我报告的幸福感降低,与生存率降低相关,这支持了衰弱作为整体糖尿病护理的一个组成部分的作用。