•  
  •  
 

ORCID ID

Hatice Yilmaz: 0009-0007-5833-2613

Nazmiye Çiray: 0000-0003-1640-9815


Abstract

Background: This study aimed to examine the effect of frailty on the risk of falls in older adults aged 65 years with type 2 diabetes.

Methods: The study is cross-sectional and correlational. The sample included 146 individuals aged 65 years who had type 2 diabetes and visited the internal medicine outpatient clinic of a state hospital in Türkiye. The participants were assessed based on a personal information form, the Mini-Mental State Examination, Edmonton Frail Scale, Morse Fall Scale, and Katz Index of Independence in Activities of Daily Living. IBM SPSS Statistics version 22.0 was used for data analysis.

Results: The mean frailty score was 5.59 ± 3.46, and 35.6% of the participants were not frail. The mean falls risk score was 45.65 ± 26.07, with a high risk of falls in 43.2% of the participants. The level of frailty, ADL score, participant age, and use of drugs other than diabetes medications explained 71.8% of the variation in the risk of falls (ß = 0.492; p < 0.001; R2 = 0.718).

Conclusions: Frailty is positively associated with the risk of falls among individuals ≥ 65 years with type 2 diabetes mellitus.

References

  1. Rachdaoui N. Insulin: The friend and the foe in the development of type 2 diabetes mellitus. Int J Mol Sci. 2020;21:1770.
  2. Freire LB, Brasil-Neto JP, da Silva ML, Miranda MGC, de Mattos Cruz L, Martins WR, et al. Risk factors for falls in older adults with diabetes mellitus: systematic review and meta-analysis. BMC Geriatr. 2024;24:201.
  3. Popoviciu MS, Paduraru L, Nutas RM, Ujoc AM, Yahya G, Metwally K, et al. Diabetes mellitus secondary to endocrine diseases: An update of diagnostic and treatment particularities. Int J Mol Sci. 2023;24:12676.
  4. Karan MA., Satman, I. Türkiye Yaşlı Sağlığı Raporu: Güncel Durum, Sorunlar ve Kısa-Orta Vadeli Çözümler [Türkiye Elderly Health Report: Current Situation, Problems and Short-Medium Term Solutions]. Istanbul: Türkiye Sağlık Enstitüleri Başkanlığı Türkiye Halk Sağlığı ve Kronik Hastalıklar Enstitüsü Yayın No: 48569; 2021. Turkish.
  5. Dutton GR, Lewis CE. The look AHEAD trial: Implications for lifestyle intervention in type 2 diabetes mellitus. Prog Cardiovasc Dis. 2015;58:69–75.
  6. Chao CT, Wang J, Chien KL; COhort of GEriatric Nephrology in NTUH (COGENT) study group. Both pre-frailty and frailty increase healthcare utilization and adverse health outcomes in patients with type 2 diabetes mellitus. Cardiovasc Diabetol. 2018;17:130.
  7. Rashedi V, Iranpour A, Mohseni M, Borhaninejad V. Risk factors for fall in elderly with diabetes mellitus type 2. Diabetes Metab Syndr. 2019;13:2347–51.
  8. Yang Y, Hu X, Zhang Q, Zou R. Diabetes mellitus and risk of falls in older adults: a systematic review and meta-analysis. Age Ageing. 2016;45:761–7.
  9. Cheng MH, Chang SF. Frailty as a risk factor for falls among community dwelling people: Evidence from a meta-analysis. J Nurs Scholarsh. 2017;49:529–36.
  10. Uchmanowicz I, Jankowska-Polańska B, Wleklik M, Lisiak M, Gobbens R. Frailty syndrome: Nursing interventions. SAGE Open Nurs. 2018;4:2377960818759449.
  11. García-de-Alba-García JE, Salcedo-Rocha AL, De-la-Rosa-Hernández S. The status of frailty in poor older adults with type 2 diabetes mellitus or hypertension: the case of Mexico. Int J Diabetes Dev Ctries. 2020;40:303–9.
  12. Düzgün G, Üstündağ S, Karadakovan A. Assessment of frailty in the elderly. Florence Nightingale J Nurs. 2021;29:2–8.
  13. Crow RS, Lohman MC, Pidgeon D, Bruce ML, Bartels SJ, Batsis JA. Frailty versus stopping elderly accidents, deaths and injuries initiative fall risk score: ability to predict future falls. J Am Geriatr Soc. 2018;66:577–83.
  14. Güngen C, Ertan T, Eker E, Yaşar R, Engin F. Standardize mini mental test'in türk toplumunda hafif demans tanisinda geçerlik ve güvenilirliği [Reliability and validity of the standardized Mini Mental State Examination in the diagnosis of mild dementia in Turkish population]. Turk Psikiyatri Derg. 2002;13:273–81. Turkish.
  15. Aygör HE, Fadıloğlu Ç, Şahin S, Aykar FŞ, Akçiçek F. Validation of edmonton frail scale into elderly Turkish population. Arch Gerontol Geriatr. 2018;76:133–7.
  16. Demir NY, İntepeler ŞS. Morse düşme ölçeğinin Türkçe’ye uyarlanması ve duyarlılık-seçicilik düzeyinin belirlenmesi [Adaptation of morse fall scale to turkish and determination of sensitivity and specificity]. Ege Üniversitesi Hemşirelik Fakültesi Dergisi. 2012;28:57–71. Turkish.
  17. Özkan Pehlivanoğlu EF, Özkan MU, Balcıoğlu H, Bilge U, Ünlüoğlu İ. Adjustment and reliability of katz daily life activity measures for elderly in Turkish. Ankara Med J. 2018;18:219–23.
  18. Kapucu S, Ünver G. Kırılgan Yaşlı ve Hemşirelik Bakımı [Fragile elderly and nursing care]. Osmangazi Tıp Dergisi. 2017;39:122–9. Turkish.
  19. de Labra C, Maseda A, Lorenzo-López L, López-López R, Buján A, Rodríguez-Villamil JL, et al. Social factors and quality of life aspects on frailty syndrome in community-dwelling older adults: The VERISAÚDE study. BMC Geriatr. 2018;18:66.
  20. Zhang L, Ding Z, Qiu L, Li A. Falls and risk factors of falls for urban and rural community-dwelling older adults in China. BMC Geriatr. 2019;19:379.
  21. Kirkwood RN, Borém IL, Sampaio RF, Ferreira VKG, de Almeida JC, Guimarães SBB, et al. Frailty status and gait parameters of older women with type 2 diabetes. Can J Diabetes. 2019;43:121–7.
  22. Chiba Y, Kimbara Y, Kodera R, Tsuboi Y, Sato K, Tamura Y, et al. Risk factors associated with falls in elderly patients with type 2 diabetes. J Diabetes Complications. 2015;29:898–902.
  23. Jehu DA, Davis JC, Falck RS, Bennett KJ, Tai D, Souza MF, et al. Risk factors for recurrent falls in older adults: A systematic review with meta-analysis. Maturitas. 2021;144:23–8.
  24. Abdelhafiz AH, Rodríguez-Mañas L, Morley JE, Sinclair AJ. Hypoglycemia in older people - a less well recognized risk factor for frailty. Aging Dis. 2015;6:156–67.
  25. Chittrakul J, Siviroj P, Sungkarat S, Sapbamrer R. Physical frailty and fall risk in community-dwelling older adults: A cross-sectional study. J Aging Res. 2020;2020:3964973.
  26. Hatano Y, Araki A, Matsumoto M, Ishibashi S. Low hemoglobin A1c and low body mass index are associated with dementia and activities of daily living disability among Japanese nursing home residents with diabetes. Geriatr Gerontol Int. 2019;19:854–60.
  27. Gale CR, Westbury LD, Cooper C, Dennison EM. Risk factors for incident falls in older men and women: the English longitudinal study of ageing. BMC Geriatr. 2018;18:117.
  28. Xu Q, Ou X, Li J. The risk of falls among the aging population: A systematic review and meta-analysis. Front Public Health. 2022;10:902599.
  29. Al-Musawe L, Martins AP, Raposo JF, Torre C. The association between polypharmacy and adverse health consequences in elderly type 2 diabetes mellitus patients; a systematic review and meta-analysis. Diabetes Res Clin Pract. 2019;155:107804.
  30. Campbell E, Petermann-Rocha F, Welsh P, Celis-Morales C, Pell JP, Ho FK, et al. The effect of exercise on quality of life and activities of daily life in frail older adults: A systematic review of randomised control trials. Exp Gerontol. 2021;147:111287.
  31. Zulfiqar AA, Habchi P, Dembele IA, Andres E. Association of frailty status with risk of fall among hospitalized elderly patients: A cross-sectional study in an acute geriatric unit. Medicines. 2022;9:48.
  32. Çinarli T, Koç Z. Fear and risk of falling, activities of daily living, and quality of life: Assessment when older adults receive emergency department care. Nurs Res. 2017;66:330–5.

Creative Commons License

Creative Commons Attribution-Share Alike 4.0 International License
This work is licensed under a Creative Commons Attribution-Share Alike 4.0 International License.

Download

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.