Current topics of frailty in association with hypertension and other medical conditions

Toba, Ayumi; Ishikawa, Joji

doi:10.1038/s41440-023-01200-6

Cited by 6 publications

(1 citation statement)

References 41 publications

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“…[69][70][71] Indeed, metformin has been advocated for its effects on longevity, frailty, and sarcopenia. [72][73][74][75] Furthermore, considering that treating hypertension in frailty and oldest old individuals represents a matter of heated debate, [76][77][78][79][80] metforminbased therapies may be endorsed in hypertensive older adults with prediabetes to prevent functional impairment and adverse events. While our findings are significant, it is essential to acknowledge the limitations of our study, including the relatively small sample size and the brief follow-up period.…”

Section: Discussionmentioning

confidence: 99%

Prediabetes Increases the Risk of Frailty in Prefrail Older Adults With Hypertension: Beneficial Effects of Metformin

Santulli,

Visco,

Varzideh

et al. 2024

Hypertension

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BACKGROUND: Prediabetes has garnered increasing attention due to its association with cardiovascular conditions, especially hypertension, which heightens the risk of prefrailty and frailty among older individuals. METHODS: We screened elders with prefrail hypertension from March 2021 to January 2023. We assessed the correlation linking cognitive dysfunction (Montreal Cognitive Assessment score), insulin resistance (triglyceride-to-glucose index), and physical impairment (5-meter gait speed). Then, we measured the risk of developing frailty after a 1-year follow-up period, adjusting the outcome using multivariable Cox regression analysis. We also investigated the impact of administering 500 mg of metformin once daily to a subset of frail subjects for an additional 6 months. RESULTS: We assessed the relationship between the triglyceride-to-glucose index and the Montreal Cognitive Assessment score, observing a significant correlation (r, 0.880; P <0.0001). Similarly, we analyzed the association between the triglyceride-to-glucose index and 5-meter gait speed, uncovering a significant link between insulin resistance and physical impairment (r, 0.809; P <0.0001). Prediabetes was found to significantly ( P <0.0001) elevate the risk of frailty development compared with individuals without prediabetes by the end of the 1-year follow-up, a finding confirmed via multivariable analysis with Cox regression. Furthermore, among the subgroup of subjects who developed frailty, those who received metformin exhibited a significant decrease in frailty levels ( P <0.0001). CONCLUSIONS: Insulin resistance and prediabetes play substantial roles in the development of cognitive and physical impairments, highlighting their importance in managing hypertension, even before the onset of frank diabetes. Metformin, a well-established drug for the treatment of diabetes, has shown favorable effects in mitigating frailty.

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