Association between comorbidities associated with diabetes and higher-level functional status in older patients with type 2 diabetes mellitus: a cross sectional study

Takuro Shoji; Kenta Kogure; Nagisa Toda; Mariko Hakoshima; Hisayuki Katsuyama; Hidekatsu Yanai; Satoshi Tokunaga; Korin Tateoka; Taishi Tsuji; Tomohiro Okura

doi:10.1007/s41999-024-00937-8

Association between comorbidities associated with diabetes and higher-level functional status in older patients with type 2 diabetes mellitus: a cross sectional study

Eur Geriatr Med. 2024 Feb 10. doi: 10.1007/s41999-024-00937-8. Online ahead of print.

Authors

Takuro Shoji^{1

2}, Kenta Kogure³, Nagisa Toda³, Mariko Hakoshima⁴, Hisayuki Katsuyama⁴, Hidekatsu Yanai⁴, Satoshi Tokunaga⁵, Korin Tateoka⁶, Taishi Tsuji⁷, Tomohiro Okura⁷

Affiliations

¹ Department of Rehabilitation Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Kohnodai 1-7-1, Ichikawa, Chiba, 272-8516, Japan. pt.shoji@hospk.ncgm.go.jp.
² Graduate School of Comprehensive Human Sciences, Doctoral Program in Public Health, University of Tsukuba, Tsukuba, Ibaraki, Japan. pt.shoji@hospk.ncgm.go.jp.
³ Department of Rehabilitation Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Kohnodai 1-7-1, Ichikawa, Chiba, 272-8516, Japan.
⁴ Department of Diabetes, Endocrinology, and Metabolism, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan.
⁵ Graduate School of Comprehensive Human Sciences, Doctoral Program in Public Health, University of Tsukuba, Tsukuba, Ibaraki, Japan.
⁶ Graduate School of Comprehensive Human Sciences, Doctoral Program in Physical Education, Health and Sport Sciences, University of Tsukuba, Tuskuba, Ibaraki, Japan.
⁷ Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.

PMID: 38340284
DOI: 10.1007/s41999-024-00937-8

Abstract

Purpose: To investigate the association between comorbidities associated with diabetes and higher-level functional status as well as the relationship between comorbidities associated with diabetes and higher-level functional status in older patients with type 2 diabetes mellitus who have better social networks.

Methods: Participants were outpatients with type 2 diabetes aged ≥ 65 years, excluding individuals with severe cardiovascular or respiratory illness, hyperglycaemic crisis, type 1 diabetes, or diabetic foot. The Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) was used to evaluate the higher-level functional status. A TMIG-IC score of ≤ 9, instrumental activities of daily living (IADL) ≤ 4, intellectual activity or social role ≤ 3 were defined as decline in higher-level functional status. The comorbidities investigated included peripheral neuropathy, retinopathy, nephropathy, cognitive impairment, depression, frailty, sarcopenia, low muscle strength, stroke, heart disease, and arthritis.

Results: The analysis included 198 patients (mean age 75.9 ± 5.7 years, male 60.1%). After adjusting for potential confounders, depression was associated with TMIG-IC (Prevalence ratio (PR) 2.34, 95% confidence interval (CI) 1.44-3.82), low muscle strength was associated with IADL (PR 2.85, 95% CI 1.30-6.27), and frailty was associated with intellectual activity (PR 1.38, 95% CI 1.10-1.74). In the model with social networks added as a confounder, the relationship between depression or low muscle strength and higher-level functional status was not statistically significant.

Conclusion: Comorbidities of depression and low muscle strength for older patients with type 2 diabetes mellitus increase the risk of malfunctioning of higher-level functional status. Increased interactions with family, friends and neighbours may reduce this event.

Keywords: Depression; Frailty; Instrumental activities of daily living; Intellectual activity; Low muscle strength; Tokyo Metropolitan Institute of Gerontology Index of Competence.

Abstract

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