Frailty and Sarcopenia as Predictors of Adverse Health Outcomes in Persons With Diabetes Mellitus

Abstract

Objectives: Diabetes mellitus is associated with premature aging, and chronic diabetes is associated with significant physical and cognitive complications. We aimed to examine frailty and sarcopenia rates and 6-month health outcomes in a clinic-based sample of patients with diabetes.

Design: This study was an observational study. Participants were recruited from June 2014 to August 2014, and follow-up was conducted 6 months after day of screening.

Setting: Participants were recruited at outpatient endocrinology, geriatric, and internal medicine clinics affiliated with Saint Louis University in St. Louis, Missouri.

Participants: Participants were persons with diabetes mellitus ages 50 to 90.

Measurements: Frailty and sarcopenia were identified using the FRAIL and SARC-F screens, respectively. A chart review of the patient's health record was performed on day of screening and at follow-up. A 6-month phone questionnaire was performed to evaluate health outcomes. Logistic regressions were used to evaluate health outcomes.

Results: A total of 198 persons with diabetes were recruited. Of the sample, 32.3% of sample was nonfrail, 38.9% was prefrail, and 28.8% was frail; 29.3% of the sample was identified to have sarcopenia. Prefrail [odds ratio (OR) 2.92, 95% confidence interval (CI) 1.15-7.42; P = .025] and frail (OR 4.70, 95% CI 1.67-13.19; P = .003) participants were more likely to be hospitalized overnight at 6-month follow-up. Frail (OR 3.57 95% CI 1.27-10.04; P = .016) participants were more likely to have a new activities of daily living (ADL) disability at follow-up; this association was not present for prefrail participants (OR 1.30, 95% CI .50-3.37; P = .59). Participants with sarcopenia were more likely to be hospitalized (OR 3.80, 95% CI 1.67-8.61; P = .001) and to have a new ADL disability (OR 4.24, 95% CI 1.76-10.18; P = .001) at 6-month follow-up.

Conclusions: Among clinic patients with diabetes mellitus ages 50-90 year old, frailty and sarcopenia prevalence is high, and both syndromes are predictors of being hospitalized overnight and new ADL disability after 6 months.

Keywords: FRAIL; Frailty; SARC-F; diabetes mellitus; sarcopenia.