Do Long-Term Complications of Type 2 Diabetes Increase Susceptibility to Geriatric Syndromes in Older Adults?

Abstract

Background and Objectives: Type 2 diabetes is one of the common chronic diseases in the elderly. It is thought that long-term complications of type 2 diabetes will negatively affect the quality of life in elderly individuals. It is possible that geriatric syndromes, especially frailty syndrome, are associated with diabetic complications, too. In this study, we aimed to evaluate the effect of macrovascular and microvascular complications of type 2 diabetes on frailty and other geriatric syndromes. In addition, the effect of these complications on quality of life was also reviewed. Materials and Methods: We conducted a cross-sectional study for four months. Comprehensive geriatric assessment tests were done on all patients. The Fried frailty index (FFI) was used for the evaluation of frailty syndrome. We assessed malnutrition by mini nutritional assessment short-form (MNA-SF), and Global Leadership Initiative on Malnutrition criteria (GLIM). The EWGSOP 2 criteria were used for the diagnosis of sarcopenia. Quality of life (QoL) was evaluated using the short form-36 (SF-36) questionnaire. Data analysis was done by SPSS version 22. Results: 237 females and 142 males with a mean age of 71.7 ± 6.1 years were included in the study. The frequency of macrovascular and microvascular complications was 41.4% and 68.1%, respectively. Frailty was found to be associated with macrovascular complications (p = 0.003). Handgrip strength, skeletal muscle mass index, and gait speed were decreased in the presence of macrovascular complications (p = 0.043, p < 0.001, p < 0.001). QoL was also decreased in patients with macrovascular complications (p = 0.003). Nutritional status and handgrip strength were negatively affected in patients with diabetic neuropathy (p = 0.019, p = 0.014). Polypharmacy was also found to be associated with macrovascular complications (p < 0.001, p < 0.001). Macrovascular complications were 2.5 times more common in malnourished patients according to GLIM and 3.2 times more common in patients with decreased gait speed. Conclusion: In this study, we observed that both macrovascular and microvascular complications of diabetes increase susceptibility to geriatric syndromes in elderly individuals. It could be useful to conduct prospective studies in which we can compare the effectiveness of treatment methods on this subject.

A higher incidence of diabetic peripheral neuropathy may be associated with decreased sleep and increased depression in older adults

“…Indeed, previous studies have shown that DPN affects both quality of life and daily functions, not only in the older adults but also in the general population (28,29). A study conducted on older adults found that DPN affects ADLs but not IADLs (8). In our study, unlike this result, we found that DPN was not associated with ADLs but could be negatively associated with IADL.…”

“…We designed this study to draw attention to these inevitable results. In the current study, we observed that the rate of diabetic neuropathy was lower in married individuals; however, in some studies examining demographic data, no significant difference was found (8).…”

“…DPN can cause walking difficulties, depression that may be associated with chronic disease, and pain. This situation may cause deterioration in the general mental and physical activities of the older adults evaluated by CGA (5,8,9). Despite its high health burden and morbidity, the conditions with which DPN may be associated have not been adequately researched in older adults.…”

“…DPN was found in 28.2% of older diabetics. They found that DPN was associated with lower Mini-Mental Status Examination, Activities of Daily Living, Instrumental Activities of Daily Living, and higher Mini Geriatric Depression Scales (8,10,11). Older adults are excluded from most studies of complications of diabetes.…”

Effect of short‐term acute moderate‐intensity resistance exercise on blood glucose in older patients with type 2 diabetes mellitus and sarcopenia

“…Blood glucose fluctuations are involved in the progression of chronic complications of diabetes through various processes. 21,22 It is thought that diabetic complications are more common in older individuals, and the macrovascular complications of diabetes were found to be associated with sarcopenia and decreased quality of life. Among microvascular complications, neuropathy is associated with possible sarcopenia and malnutrition.…”