Diabetes, frailty and burden of comorbidities among older Malaysians with stroke

Abstract

Background Stroke is a global health challenge. The increasing prevalence of diabetes and the ageing population further add to the complexities of stroke care. Objective This study aims to (1) describe the prevalence of diabetes in older patients with stroke and (2) compare the burden of comorbidities among patients with diabetes and frailty compared to those without these conditions. Methods This was a cross-sectional study in older patients aged ≥ 65 years with stroke. Comorbidities were assessed using the Charlson Comorbidity Index (CCI). Frailty assessments were done using the Clinical Frailty Scale. Participants were classified into four groups: Group 1, frail and diabetic; Group 2, non-frail and diabetic; Group 3, frail and non-diabetic; and Group 4, non-frail and non-diabetic. Results There were 384 participants (mean age 81.11 ± 6.37). Diabetes was present in 45.1%. The mean CCI was highest for the frail and diabetic group (6.97 ± 1.97), followed by non-frail and diabetic (6.00 ± 2.02), frail and non-diabetic (5.49 ± 1.79) and non-frail and non-diabetic (4.74 ± 1.68), p < 0.001. The non-frail and diabetic group had a significantly higher prevalence of hypertension (96.9%) and ischaemic heart disease (34.4%) compared to the other three groups. Conclusions There was a high prevalence of diabetes among older patients with stroke. While the frail and diabetic group had the highest overall burden of comorbidities, the non-frail and diabetic group had the most significant cardiovascular disease burden. These findings highlight the urgent need for integrated and personalized management approaches to enhance the overall well-being and quality of life for older stroke survivors with diabetes.