Surprising predictions part 4

 The Scary Reality of Frailty in Older Patients with Diabetes

Research has shown that the prevalence of frailty in older adults with diabetes in China is significantly higher than their counterparts without diabetes, as well as people without diabetes of the same age and older adults without diabetes across different populations. In addition, older adults with diabetes tend to have an earlier onset of frailty than those without it, which can contribute to an increased risk of developing a number of complications including cardiovascular disease and metabolic syndrome. But what exactly does this mean?

What is Frailty?

In general, frailty is a syndrome that is characterized by five domains: (1) physical activity or fatigue, (2) nutritional status, (3) cognitive function, (4) bone mass and muscle strength, and (5) clinical diagnosis. Recently a sixth domain has been added to the definition which includes social engagement. People who are considered to be frail have many but not all of these qualities; people who are pre-frail only exhibit one or two criteria and would most likely become frail within a given time frame. People who do not fall into either category typically refer to themselves as robust. In this study, researchers looked at 2,005 adults between the ages of 60 and 99 years old who had diabetes in China. The study found that 792 participants were defined as having some level of frailty while 282 participants were classified as being pre-frail. Participants who had suffered from acute complications such as stroke, heart attack, amputation or head injury during their lifetime were twice as likely to be frail than those without any chronic conditions. Older adults with diabetes who also had coronary artery disease were more than three times more likely to be frail than those without coronary artery disease. Women were 1.7 times more likely to be frail than men and women were four times more likely to suffer from pre-frailty. Participants who lived alone, did not work outside the home, and had low levels of education were more likely to be frail. Those who smoked cigarettes on a regular basis were almost three times as likely to be frail or pre-frail than nonsmokers. However, when smoking was broken down by type of cigarette (regular vs. filtered), it was seen that smokers of regular cigarettes were only half as likely to be frail or pre-frail than those who smoked filtered cigarettes. Researchers hypothesized that the difference may be due to the toxic chemicals contained in tobacco smoke. More research needs to be done before a definite conclusion can be made. 

A Word about Pre-Frailty: Pre-frailty is becoming an increasingly important issue for health care providers because it allows for earlier interventions before individuals actually become frail. The results of this study suggest interventions should focus on increasing physical activity, reducing weight gain, and providing education about nutrition and food intake among other things. These treatments may help slow progression towards frailty or even reverse its onset altogether

What Does Pre-Frail Mean?

You might be wondering what pre-frail is and if you should be concerned. The term refers to people who may be experiencing physical declines that increase their risk for falls and loss of independence but are not yet frail. They're at risk, though, and should consider the other six risk factors below: 

 * poor vision or hearing * cognitive impairment (e.g., dementia) * peripheral vascular disease (blood circulation problems) * prior stroke or transient ischemic attack (TIA) * severe mood disorder (e.g., depression or anxiety) * dependence on others for activities of daily livingliving (ADLs), such as dressing oneself or getting out of bed

What Should You Do If You or Your Loved One Is Frail or Pre-Frail?

1. Educate yourself on the factors that can increase your chances of becoming frail or pre-fradigly, such as obesity, lack of mobility, and social isolation. 

2. Speak to your doctor if you think you're nearing frailty status and work together to come up with a plan for moving towards healthier habits that will slow the progression down. 

3. Monitor your blood sugar level, since diabetes has been found to be one of the leading factors for increased frailty rates in seniors. 

4. Take regular walks outside and do physical activity if possible; this will increase circulation in your body which could help ward off dangerous side effects from being sedentary for too long like heart disease and type 2 diabetes. 5. Make sure to get enough sleep! The National Sleep Foundation recommends adults aged 65+ get 7-8 hours of sleep per night, but studies have shown some need more and others less. 6. If you are living alone make sure there is an emergency contact person in case something happens when you're sleeping or during other times when someone is not able to reach you at home. Consider installing smoke detectors in your home and having them tested regularly by professionals. Be careful about taking care of any animals you may have; they are living beings who need their own food, water, shelter, etc., just like humans. 7. Have conversations with loved ones about what you want out of life should anything happen, whether it's your idea or theirs. Don't be afraid to take time for introspection and self-care even if it feels selfish - know that it's worth it! You deserve to feel good and live happily knowing that you are doing everything in your power to keep yourself healthy so you can enjoy those around you. As always, we would love to hear your thoughts on these points and would appreciate any feedback. We look forward to hearing from you soon. In the meantime, please share this post with your friends and family. Share it everywhere, because the more people who know how to protect themselves against the harmful effects of diabetes and aging, the better. Thank you for reading.

What Makes An Older Person Frail? Section 1) Sociodemographic Characteristics Section 2) Clinical, Laboratory, Radiological and Functional Characteristics Section 3) Health Care Utilization Section 4) Additional Observations

We observed higher prevalence of frailty in older patients with diabetes, which is similar to previous studies. Clinical examination and laboratory parameters may help identify frailty or pre-frailty status among diabetic patients. Predisposing factors include female sex, urban residency, chronic disease burden, social support and functional capacity. Referral for physical therapy is warranted for people who are post-stroke or have a low level of functional capacity. The present study has identified that diabetic patients are at risk for functional decline due to comorbidities, multiple disease burden and lack of physical activity; these individuals should be counseled on the importance of exercise. Further research into the prevention of functional decline through education programs is necessary. Previous studies have shown that stroke recovery can be improved by aerobic exercise such as tai chi and cycling exercises. When appropriate, rehabilitation specialists should work closely with primary care physicians and other providers to provide recommendations for additional interventions as needed. While frail older adults in China need to be assessed for adequate medical treatment and medications, it is important to consider their home environment (including living arrangements) as well as their social relationships when planning long-term care needs. Healthcare providers must also take into account lifestyle habits (such as smoking) when assessing frailty since these are significant determinants of age-related morbidity and mortality.