Burden of comorbidities among older Malaysians with stroke: Associations with diabetes mellitus and frailty

Abstract

Background and aims The increasing prevalence of diabetes and the growing population of older people further adds to the complexities of stroke care. This study aimed to describe (1) prevalence of diabetes in older persons with stroke and (2) compare the burden of comorbidities and cardiovascular risk factors among patients with diabetes and frailty compared to those without these conditions. Methods We conducted an analysis of older patients aged ≥ 65 years. Comorbidities were assessed using the Charlson Comorbidity Index (CCI). Frailty assessments were performed using the Clinical Frailty Scale (CFS) version 2. Results A total of 384 participants were included for analysis, mean age of 81.11 ± 6.373. Diabetes was present in 45.1%. The prevalence of frailty was 81.3% in those with diabetes and 70.5% in those without diabetes. The mean CCI was highest for the frail and diabetic group (6.97 ± 1.97). Participants with diabetes also had a significantly higher prevalence of risk factors like hypertension (90.8% versus 74.4%, p <0.001) and cardiovascular disease like ischemic heart disease (27.2% versus 14.8%, p =0.003). Conclusions There was a very high prevalence of diabetes in older patients with stroke in this study. Besides the management of diabetes, frailty and cardiovascular risk factors are potential target areas that healthcare providers can strive to address to enhance the overall well-being and quality of life for older stroke survivors with diabetes.