| Title: | An analysis of frailty and multimorbidity in 20,566 UK Biobank participants with type 2 diabetes |
| Journal: | Communications Medicine |
| Published: | 27 Aug 2021 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/35602215/ |
| DOI: | https://doi.org/10.1038/s43856-021-00029-9 |
| URL: | https://www.nature.com/articles/s43856-021-00029-9.pdf |
Publication 10041
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Abstract
BackgroundFrailty and multimorbidity are common in type 2 diabetes (T2D), including people <65 years. Guidelines recommend adjustment of treatment targets in people with frailty or multimorbidity. It is unclear how recommendations to adjust treatment targets in people with frailty or multimorbidity should be applied to different ages. We assess implications of frailty/multimorbidity in middle/older-aged people with T2D.MethodsWe analysed UK Biobank participants (n = 20,566) with T2D aged 40-72 years comparing two frailty measures (Fried frailty phenotype and Rockwood frailty index) and two multimorbidity measures (Charlson Comorbidity index and count of long-term conditions (LTCs)). Outcomes were mortality, Major Adverse Cardiovascular Event (MACE), hospitalization with hypoglycaemia or fall/fracture.ResultsHere we show that choice of measure influences the population identified: 42% of participants are frail or multimorbid by at least one measure; 2.2% by all four measures. Each measure is associated with mortality, MACE, hypoglycaemia, and fall or fracture. The absolute 5-year mortality risk is higher in older versus younger participants with a given level of frailty (e.g. 1.9%, and 9.9% in men aged 45 and 65, respectively, using frailty phenotype) or multimorbidity (e.g. 1.3%, and 7.8% in men with 4 LTCs aged 45 and 65, respectively). Using frailty phenotype, the relationship between higher HbA1c and mortality is stronger in frail compared with pre-frail or robust participants.ConclusionsAssessment of frailty/multimorbidity should be embedded within routine management of middle-aged and older people with T2D. Method of identification as well as features such as age impact baseline risk and should influence clinical decisions (e.g. glycaemic control).</p>
7 Authors
- Peter Hanlon
- Bhautesh D. Jani
- Elaine Butterly
- Barbara Nicholl
- Jim Lewsey
- David A. McAllister
- Frances S. Mair
1 Application
| Application ID | Title |
|---|---|
| 14151 | Exploring multimorbidity in UK Biobank ? patterns of illness reporting and effects of comorbidity and multimorbidity on health outcomes |
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