目的:在具有较好社交网络的老年2型糖尿病患者中,探讨与糖尿病相关的合并症与高级功能状态之间的关系,以及与糖尿病相关的合并症与高级功能状态之间的关系。
方法:受试者为年龄≥65岁的2型糖尿病门诊患者,不包括患有严重心血管或呼吸系统疾病的人,高血糖危机,1型糖尿病,或者糖尿病足.东京都老年学能力指数研究所(TMIG-IC)用于评估更高级别的功能状态。TMIG-IC评分≤9,日常生活工具活动(IADL)≤4,智力活动或社会角色≤3被定义为高级功能状态的下降。调查的合并症包括周围神经病变,视网膜病变,肾病,认知障碍,抑郁症,脆弱,少肌症,肌肉力量低,中风,心脏病,和关节炎。
结果:分析包括198名患者(平均年龄75.9±5.7岁,男性60.1%)。在调整了潜在的混杂因素后,抑郁症与TMIG-IC(患病率比(PR)2.34,95%置信区间(CI)1.44-3.82)相关,低肌力与IADL相关(PR2.85,95%CI1.30-6.27),和虚弱与智力活动相关(PR1.38,95%CI1.10-1.74)。在添加社交网络作为混淆者的模型中,抑郁或低肌力与高级功能状态之间的关系无统计学意义.
结论:老年2型糖尿病患者的抑郁和低肌力合并症增加了高级功能状态功能障碍的风险。增加与家人的互动,朋友和邻居可能会减少这个事件。
OBJECTIVE: 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.
CONCLUSIONS: 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.