Frailty Syndrome and sarcopenia in older adults with and without type 2 diabetes mellitus in the municipality of Sinop, Mato Grosso: an epidemiological study

Cunha, Alan Nogueira da; Zanetti, Maria Lucia; Santos, Jair Licio Ferreira; Rodrigues, Rosalina Aparecida Partezani

doi:10.1590/1518-8345.6677.4077

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Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 31 • 2023 • https://doi.org/10.1590/1518-8345.6677.4077 copy

Frailty Syndrome and sarcopenia in older adults with and without type 2 diabetes mellitus in the municipality of Sinop, Mato Grosso: an epidemiological study ^* * Paper extracted from doctoral dissertation “Síndrome da Fragilidade associado à sarcopenia em pessoa idosas com e sem diabetes mellitus tipo 2 do município de Sinop, Mato Grosso: um estudo epidemiológico”, presented to Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

to relate Frailty Syndrome and sarcopenia in older adults with and without type 2 diabetes mellitus and identify potential risk factors for frailty and sarcopenia.

Method:

this descriptive epidemiological study was conducted with 140 older adults in the municipality of Sinop, Mato Grosso, Brazil. The frailty phenotype was used for the assessment of Frailty Syndrome, and a physical assessment questionnaire with calf circumference measurement was used for the assessment of sarcopenia.

Results:

regarding Frailty Syndrome, a higher percentage was observed in older adults with type 2 diabetes mellitus compared to those without the disease (p = 0.00). Concerning the presence of sarcopenia, older adults with and without type 2 diabetes mellitus showed similar values, with no statistical significance (p = .74). Frailty Syndrome was associated with physical inactivity (95%CI: 3.29-56.55), age over 75 years (95%CI: 3.30- 27.82), low family income (95%CI: 1.80-50.98), and comorbidities (95%CI: 4.90-5.40). However, sarcopenia was associated with the presence of physical inactivity (95%CI: 1.26-10.44), low weight/ eutrophic (95%CI: 3.32-26.76), and malnutrition/nutritional risk (95%CI: 1.30-7.70) for older adults with and without type 2 diabetes mellitus.

Conclusion:

older adults with diabetes have a higher vulnerability to develop Frailty Syndrome, necessitating the adoption of preventive measures in primary healthcare.

Descriptors:
Aged; Diabetes Mellitus; Frailty; Sarcopenia; Primary Health Care; Nursing

Highlights:

(1) Frailty and sarcopenia, important syndromes to be assessed in older adults.

(2) Older adults with T2DM have a higher vulnerability for the development of frailty.

(3) The nurse should implement measures to prevent frailty and sarcopenia.

Variable		Older adults with T2DM*		Older adults without T2DM*
Variable		n	%	n	%
Sex	Male	31	44,28	31	44,28
Sex	Female	39	55,71	39	55,71
Age group (years)	60 to 64	14	20,00	11	15,71
	65 to 69	15	21,40	17	24,28
	70 to 74	14	20,00	15	21,40
	75 to 79	12	17,14	10	14,28
	>80	15	21,40	17	24,28
Self-reported skin color	White	40	57,14	47	67,14
	Brown	24	34,29	21	30,00
	Black	4	5,71	5	7,14
	Indigenous	2	2,86	1	1,43
Marital status	Single	3	4,29	7	10.00
	Married	36	51,43	44	62,86
	Divorced	9	12,86	5	7,14
	Separated	2	2,86	1	1,43
	Widowed	20	28,57	13	18,57
Education	Up to 4 years of education	52	74,28	44	62,85
Education	More than 4 years of education	18	25,71	26	37,14
Living arrangements	Alone	15	21,43	6	8,57
	Only with spouse	22	31,43	30	42,86
	Spouse and child(ren)	11	15,71	9	12,86
	Spouse, children, son-in-law or daughter-in-law	2	2,86	5	7,14
	Only with child(ren)	8	11,43	3	4,29
	Three-generation arrangements	9	12.86	15	21,43
	Intra-generational arrangements	1	1,43	0	0
	Only with grandchildren	1	1,43	1	1,43
	Non-family members	1	1,43	1	1,43
Family income in minimum wages ^† in Brazilian Reais	1	13	18,57	8	11,43
	2	22	31,43	24	34,29
	3	29	41,43	30	42,86
	4	3	4,29	6	8,57
	5	2	2,86	2	2,86
	Do not know	1	1,43	0	0

Older adults with T2DM* n = 70						Older adults without T2DM* n = 70
Variable	Mean	Median	SD ^†	Min ^‡	Max ^§	Mean	Median	SD ^†	Min ^‡	Max ^§
WC ^\|\|	101.31	100.0	13.46	55.0	141.0	97.78	100.0	11.39	74.0	133.0
HC ^¶	106.07	104.0	10.39	80.0	143.0	103.31	99.0	8.79	88.0	126.0
Weight	73.96	71.2	15.22	40.0	131.0	72.44	71.0	17.95	45.0	168.0
Height	160.95	164.0	12.37	120.0	186.0	164.04	163.0	9.01	143.0	181.0
BMI**	28.04	27.3	5.38	16.0	48.7	26.33	26.9	4.61	19.3	38.0
HbA1c ^††	6.80	5.8	1.40	3.9	11.9	5.80	5.8	0.40	4.7	7.3
Comorbidities	7.00	5.0	3.70	0.0	16.0	5.00	5.0	2.70	0.0	16.0

Variables		Frailty n(%)				Sarcopenia n(%)
Variables		Not frail	Pre-frail	Frail	p	Without sarcopenia	With sarcopenia	p
Sex	Male	8 (5.7)	19 (13.5)	35 (25.0)	0.28	43 (30.7)	19 (13,5)	0.57
Sex	Female	18 (12.8)	19 (13.0)	41 (29.2)	0.28	54 (38.5)	24 (17.1)	0.57
TOTAL n(%)		26 (18,5)	38 (27.1)	76 (54.2)		97 (69.2)	43 (30.8)
Age group	Up to 75	21 (15.0)	19 (13.5)	17 (12.1)	0.00	68 (48.5)	21 (15.0)	0.01
Age group	75 and over	5 (3.5)	19 (13.5)	59 (42.1)	0.00	29 (20.7)	22 (15.7)	0.01
TOTAL n(%)		26 (18.5)	38 (27.1)	76 (5402.0)		97 (69.3)	43 (30.7)
MNA ^†	Normal	21 (15.0)	27 (19.2)	51 (3604.0)	0.69 (*)	78 (55.7)	21 (15.0)	0.00 (*)
	Nutritional risk	5 (3.5)	10 (7.1)	22 (1507.0)		19 (13.5)	18 (12.8)
	Malnourished	0(0.0)	1(0.7)	3(2.1)		0(0.0)	4(2.8)
TOTAL n(%)		26(18.5)	38(27.1)	76(54.2)		97(69.3)	43(30.7)
Multimorbidities	Up to 5	24(17.1)	30(21.4)	44(31.4)	0.00	65(46.4)	32(22.8)	0.32
Multimorbidities	More than 5	2(1.4)	8(5.7)	32(21.4)	0.00	33(23.5)	10(7.1)	0.32
TOTAL n(%)		26(18.5)	38(27.2)	76(52.8)		98(70.0)	42(30.0)

Variable		Odds Ratio	p ^†	95% IC ^‡
Frailty	Body Mass Index	0.18	0.00	0.06	0.54
	Physical inactivity	13.64	0.00	3.29	56.55
	Over 75 years age group	9.18	0.00	3.30	27.82
	Family income ^§	9.58	0.00	1.80	50.98
	More than 5 comorbidities	3.77	0.01	1.36	10.48
	Marital status	1.29	0.59	0.49	0.54
Sarcopenia	Physical inactivity	3.64	0.01	1.26	10.44
	Over 75 years age group	1.45	0.71	0.51	4.10
	Body Mass Index	9.43	0.00	3.32	26.76
	Education less than 4 years	1.66	0.37	0.54	5.10
	Family income less than 1 MW ^§	1.59	0.71	0.44	5.72
	Nutritional risk and/or malnourished	3.16	0.01	1.30	7.70

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E-mail: rlae@eerp.usp.br

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[1] Corresponding author:
Alan Nogueira da Cunha E-mail: enf.alannc@hotmail.com https://orcid.org/0000-0002-5424-8947