Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy, Fudan University, Shanghai 201203, China.
Minhang Hospital, School of Pharmacy, Fudan University, Shanghai 201199, China.
Int J Environ Res Public Health. 2022 Jul 26;19(15):9092. doi: 10.3390/ijerph19159092.
Background: Evidence is lacking on risk factors for frailty and prefrailty and their relationship with self-management behaviors in patients ≥40 years of age with type 2 diabetes. Methods: Participants were selected as a cross-sectional cohort at five communities in Shanghai, China during January−March 2021. The modified FRAIL scale and the Summary of Diabetes Self-Care Activities (SDSCA) measure were used. Results: Of the 558 participants, 10.2% were classified as frailty and 34.1% as prefrailty. The prevalence of frailty was higher in males than in females (p = 0.009), whereas females were associated with higher odds of prefrailty (aOR 1.67, 95% CI [1.08−2.60]). Multimorbidity, ≥3 chronic diseases, and hospitalization in the past year were considered risk factors for both frailty and prefrailty. Each point earned on SDSCA and physical activity were associated with lower odds of frailty (aOR 0.95, 95% CI [0.92−0.98]) and prefrailty (aOR 0.52, 95% CI [0.31−0.85]), respectively. Frail participants performed significantly worse self-care practice than prefrail and non-frail ones, especially on diet, physical activity, and medication adherence (p < 0.001). Conclusions: Frail patients ≥40 years of age with type 2 diabetes reported poorer self-care performance. Further interventional studies are warranted to clarify their causal relationship.
缺乏 40 岁及以上 2 型糖尿病患者虚弱和衰弱前期的风险因素及其与自我管理行为的关系的证据。方法:2021 年 1 月至 3 月,在中国上海的五个社区选择参与者进行横断面队列研究。使用改良 FRAIL 量表和糖尿病自我护理活动综合评估量表(SDSCA)进行评估。结果:558 名参与者中,10.2%被归类为虚弱,34.1%为衰弱前期。男性的虚弱发生率高于女性(p=0.009),而女性更易出现衰弱前期(aOR 1.67,95%CI [1.08-2.60])。多种合并症、≥3 种慢性疾病和过去一年的住院治疗被认为是虚弱和衰弱前期的危险因素。SDSCA 和身体活动每增加 1 分,与虚弱(aOR 0.95,95%CI [0.92-0.98])和衰弱前期(aOR 0.52,95%CI [0.31-0.85])的几率降低相关。虚弱患者的自我护理实践明显差于衰弱前期和非虚弱患者,尤其是在饮食、身体活动和药物依从性方面(p<0.001)。结论:40 岁及以上 2 型糖尿病虚弱患者报告的自我护理效果较差。需要进一步的干预研究来阐明它们之间的因果关系。