Clinical impacts of frailty on 123,172 people with diabetes mellitus considering the age of onset and drugs of choice: a nationwide population-based 10-year trajectory analysis.
Aims Frailty substantially increased the risk of adverse clinical outcomes, which was also critical in diabetes management. This study aimed to investigate the interrelationships between the age of onset, frailty, anti-diabetic medications and clinical outcomes in people with diabetes mellitus (DM)....
| Publicado en: | Age & Ageing Vol. 52; no. 7; pp. 1 - 12 |
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| Autores principales: | , , |
| Formato: | Artículo |
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Oxford University Press / USA
Jul2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=169328719&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 169328719 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Jul2023 vid: 52 iid: 7 pid: 622 pub: Oxford University Press / USA artinfo: ui: 169328719 10.1093/ageing/afad128 ppf: 1 ppct: 11 formats: tig: atl: Clinical impacts of frailty on 123,172 people with diabetes mellitus considering the age of onset and drugs of choice: a nationwide population-based 10-year trajectory analysis. aug: au: Huang, Shih-Tsung Chen, Liang-Kung Hsiao, Fei-Yuan affil: Department of Pharmacy, National Yang Ming Chiao Tung University , Taipei , Taiwan Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University , Taipei , Taiwan Center for Geriatrics and Gerontology, Taipei Veterans General Hospital , Taipei , Taiwan Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital) , Taipei , Taiwan Graduate Institute of Clinical Pharmacy , College of Medicine, National Taiwan University , Taipei , Taiwan School of Pharmacy , College of Medicine, National Taiwan University , Taipei , Taiwan Department of Pharmacy, National Taiwan University Hospital , Taipei , Taiwan su: Diagnosis of diabetes Mortality Diabetes Hospital care Diabetes complications Frail elderly Confidence intervals Major adverse cardiovascular events Glycemic control Hypoglycemic agents Health outcome assessment Age factors in disease Research funding Descriptive statistics Hypoglycemia Proportional hazards models Longitudinal method sug: subj: Diagnosis of diabetes Mortality Diabetes Hospital care Diabetes complications Frail elderly Confidence intervals Major adverse cardiovascular events Glycemic control Hypoglycemic agents Health outcome assessment Age factors in disease Research funding Descriptive statistics Hypoglycemia Proportional hazards models Longitudinal method keyword: diabetes mellitus frailty hypoglycaemia major adverse cardiovascular events (MACEs) mortality older people diabetes mellitus frailty hypoglycaemia major adverse cardiovascular events (MACEs) mortality older people ab: Aims Frailty substantially increased the risk of adverse clinical outcomes, which was also critical in diabetes management. This study aimed to investigate the interrelationships between the age of onset, frailty, anti-diabetic medications and clinical outcomes in people with diabetes mellitus (DM). Methods A total of 123,172 people aged 40 years and older who were newly diagnosed with DM were identified and categorised into four frailty subgroups (robust, mild, moderate and severe) based on the multimorbidity frailty index (mFI). Cox proportional hazards models were used to examine associations between frailty and clinical outcomes at different ages of DM onsets (40–64, 65–74, 75–84 and 85+ years). Outcomes of interest included generic outcomes (mortality and unplanned hospitalisation) and DM-related outcomes (cardiovascular disease-related mortality, major adverse cardiovascular events (MACEs), diabetes-related hospitalisation and hypoglycaemia). Results The proportion of frailty increased with age at diagnosis amongst people with incident DM and the mFI scores increased significantly during the 10-year follow-up. Amongst people with diabetes, those with mild, moderate and severe frailty were associated with greater risks of all-cause mortality (mild: adjusted hazard ratio (aHR) 1.69 [95% confidence interval (CI) 1.60–1.80], P < 0.01; moderate: aHR 2.46 [2.29–2.65], P < 0.01; severe frailty: aHR 3.40 [3.16–3.65], P < 0.01) compared with the robust group. Similar results were found in unplanned hospitalisations, cardiovascular disease-related mortality, MACEs and hypoglycaemia. Conclusions Our study quantified the prevalence of frailty, captured its dynamic changes and examined its impacts on various clinical outcomes amongst people with diabetes at different ages at onset. Frailty assessment and management should be implemented into routine diabetes care. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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