Our study found a worrisome increase in MI mortality between 2012-2016 in Ecuador, a middle-income country in South America. This rapid increase seems to be driven by geographic and racial differences. A thorough evaluation of the causes of this increase has to be undertaken by the Ecuadorian health authorities.

Frailty is a state of vulnerability to stressors resulting in higher morbidity, mortality and healthcare utilization in older adults. Diabetes mellitus is considered a risk factor for both frailty and falls in older adults. The aim of this study was to determine in a community cohort of older patients (65 years and older) with type 2 diabetes mellitus (T2DM) whether a history of falls is associated with frailty. Community dwelling older Veterans with T2DM underwent frailty assessment with the validated 5-item FRAIL Scale (frail ≥ 3; pre-frail 1-2; robust 0 points) between January 2016 and December 2017. We aggregated data on patients with a least one fall in the previous year. Binomial logistic regression was used to examine the association between a history of falls in the previous year and frailty. Among 868 patients (mean age 74 ± 7 years, 98% men), 31% were robust, 36% prefrail, and 33% frail. Over the previous year, 164 falls occurred among 1older patients. The number of older individuals with at least one fall in the previous year was significantly higher in the frail as compared with prefrail and robust groups: 20%, 9%, and 9% respectively (p<.0005). A history of falls in the previous year was associated with an increased risk for frailty (odds ratio: 2.54 95% CI: 1.60-4.03). The population-attributable risk associated with a history of falls was 44% for frailty. In conclusion, a history of falls in the previous year is a strong predictor of frailty in older patients with T2DM. Falls should be a key component of the clinical evaluation of older patients with T2DM. Disclosure W. Valencia: None. N. Moghadam: None. J. Balda-Canizares: None. M.J. Mintzer: None. S. Dang: None. J.G. Ruiz: None.