Diabetes and Muscle Dysfunction in Older Adults

Abstract

Aging and diabetes are both risk factors for functional decline or disability in older adults with diabetes. Recent studies demonstrated that the presence of diabetes significantly increases the risk of sarcopenia, frailty, and geriatric syndrome including falls, hospitalization, disability, and mortality in older adults. They have also suggested that sarcopenia, frailty, and geriatric syndrome should be categorized as a third category of complications in addition to the traditional micro- and macro-vascular complications leading to disability in older adults with diabetes. Prevention of functional decline is a crucial strategy in geriatric management. Recovery of functional independence from dependence or disability is uncommon and lengthy. Assessments of functional status and geriatric syndrome including sarcopenia or frailty should be mandatory in older adults with diabetes to promote early interventions based on physical exercise and nutrition education. This brief review discussed age-associated and diabetes-associated muscle changes and their association with functional decline.

Keywords: Diabetes mellitus; Dysfunction; Frailty; Sarcopenia; Skeletal muscle.

Fig. 1.

Additive effects of aging and diabetes on muscle dysfunction. Sarcopenia is a major component of frailty. Diabetes accelerates the progression of sarcopenia to frailty, ultimately leading to disability, functional dependence, and death. Geriatric syndrome includes falls, incontinence, pressure ulcer, delirium, functional dependence.