THE EFFECT OF FRAILTY ON BALANCE AND FALL RISK IN TYPE 2 DIABETIC PATIENTS

Authors

  • GULSAH TURANOGLU Department of Physiotherapy and Rehabilitation, Kirikkale University, Kirikkale, Turkey. https://orcid.org/0000-0002-2646-874X
  • MERAL SERTEL Department of Physiotherapy and Rehabilitation, Kirikkale University, Kirikkale, Turkey.

DOI:

https://doi.org/10.55197/bgsttf02

Keywords:

diabetes mellitus, balance, fall risk, frailty

Abstract

The aim of this study was to examine the effect of frailty on balance and fall risk in individuals with type 2 diabetes mellitus (DM). A total of 50 individuals diagnosed with type 2 DM, including 25 frail and 25 non-frail individuals were included in the study. The demographic information of the individuals was collected using a prepared case data form. The frailty status of the individuals was evaluated using the Fried Frailty Index. Their cognitive status was assessed using the Standardized MiniMental Test (SMMT), fall risk was evaluated using the Self-Rated Fall Risk Questionnaire (FRQ) and the Falls Efficacy Scale-International. Balance assessment was conducted using the Tinetti Balance and Gait Assessment, Functional Reach Test and Timed Up and Go Test (TUG). The results of our study showed that the mean age of the frail group with type 2 diabetes was 69.08±4.17 years, while it was 67.96±3.41 years for the non-frail group. The average BMI of the individuals was found to be 29.42±3.81, and there was no significant difference in BMI values between the frail and non-frail groups. Statistical analysis revealed significant differences between the groups in Falls Efficacy Scale-International, FRQ, Tinetti Balance and Gait Assessment, Functional Reach Test, and TUG results (p<0.05). It was determined that individuals with type 2 diabetes who are frail have worse balance and a higher risk of falls compared to non-frail individuals. Fraility in individuals with Type 2 Diabetes can significantly affect balance and fall risk.

References

Angulo, J., El Assar, M., Álvarez-Bustos, A., Rodríguez-Mañas, L. (2020): Physical activity and exercise: Strategies to manage frailty. – Redox Biology 35: 21p.

Angulo, J., El Assar, M., Rodriguez-Manas, L. (2016): Frailty and sarcopenia as the basis for the phenotypic manifestation of chronic diseases in older adults. – Molecular Aspects of Medicine 50: 1-32.

Assar, M.E., Angulo, J., Rodríguez‐Mañas, L. (2016): Diabetes and ageing‐induced vascular inflammation. – The Journal of Physiology 594(8): 2125-2146.

Brownrigg, J.R., Hughes, C.O., Burleigh, D., Karthikesalingam, A., Patterson, B.O., Holt, P.J., Thompson, M.M., de Lusignan, S., Ray, K.K., Hinchliffe, R.J. (2016): Microvascular disease and risk of cardiovascular events among individuals with type 2 diabetes: a population-level cohort study. – The Lancet Diabetes & Endocrinology 4(7): 588-597.

Castro-Rodríguez, M., Carnicero, J.A., Garcia-Garcia, F.J., Walter, S., Morley, J.E., Rodríguez-Artalejo, F., Sinclair, A.J., Rodríguez-Mañas, L. (2016): Frailty as a major factor in the increased risk of death and disability in older people with diabetes. – Journal of the American Medical Directors Association 17(10): 949-955.

Davies, B., García, F., Ara, I., Artalejo, F.R., Rodriguez-Mañas, L., Walter, S. (2018): Relationship between sarcopenia and frailty in the Toledo study of healthy aging: a population based cross-sectional study. – Journal of the American Medical Directors Association 19(4): 282-286.

Duncan, P.W., Weiner, D.K., Chandler, J., Studenski, S. (1990): Functional reach: a new clinical measure of balance. – Journal of Gerontology 45(6): M192-M197.

International Diabetes Federation (2021): Diabetes now affects one in 10 adults worldwide. – International Diabetes Federation Web Portal 7p.

Fried, L.P., Tangen, C.M., Walston, J., Newman, A.B., Hirsch, C., Gottdiener, J., Seeman, T., Tracy, R., Kop, W.J., Burke, G., McBurnie, M.A. (2001): Frailty in older adults: evidence for a phenotype. – The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 56(3): M146-M157.

Gregg, E.W., Cheng, Y.J., Srinivasan, M., Lin, J., Geiss, L.S., Albright, A.L., Imperatore, G. (2018): Trends in cause-specific mortality among adults with and without diagnosed diabetes in the USA: an epidemiological analysis of linked national survey and vital statistics data. – The Lancet 391(10138): 2430-2440.

Güngen, C., Ertan, T., Eker, E., Yaşar, R., Engin, F. (2002): Reliability and validity of the standardized Mini Mental State Examination in the diagnosis of mild dementia in Turkish population. – Turk Psikiyatri Dergisi=Turkish Journal of Psychiatry 13(4): 273-281.

Hewston, P., Deshpande, N. (2018): Fear of falling and balance confidence in older adults with type 2 diabetes mellitus: a scoping review. – Canadian Journal of Diabetes 42(6): 664-670.

İdiz, C., Yılmaz, Ö. , Gül, N. , Tekin, S. , Çakmak, R. , Ören, M.M. , Gürkaş, S. , Karan, M.A. , Bahat, G., Satman, İ. (2021): WHAT ARE THE FACTORS AFFECTING THE FRAILTY OF ELDERLY PEOPLE WITH TYPE 2 DIABETES? – Journal of Istanbul Faculty of Medicine 84(1): 1-8.

Kapucu, S., Ünver, G. (2017): Fragile elderly and nursing care. – Osmangazi Medical Journal 39(1): 122-129.

Kautzky-Willer, A., Harreiter, J., Pacini, G. (2016): Sex and gender differences in risk, pathophysiology and complications of type 2 diabetes mellitus. – Endocrine Reviews 37(3): 278-316.

Kotsani, M., Chatziadamidou, T., Economides, D., Benetos, A. (2018): Higher prevalence and earlier appearance of geriatric phenotypes in old adults with type 2 diabetes mellitus. – Diabetes Research and Clinical Practice 135: 206-217.

Kukidome, D., Nishikawa, T., Sato, M., Nishi, Y., Shimamura, R., Kawashima, J., Shimoda, S., Mizuta, H., Araki, E. (2017): Impaired balance is related to the progression of diabetic complications in both young and older adults. – Journal of Diabetes and Its Complications 31(8): 1275-1282.

Moretto, M.C., Fontaine, A.M., Garcia, C.A., Neri, A.L., Guariento, M.E. (2016): Association between race, obesity and diabetes in elderly community dwellers: data from the FIBRA study. – Cad Saude Publica 32(10): 11p.

Morrison, S., Colberg, S.R., Mariano, M., Parson, H.K., Vinik, A.I. (2010): Balance training reduces falls risk in older individuals with type 2 diabetes. – Diabetes Care 33(4): 748-750.

Mustapa, A., Justine, M., Mohd Mustafah, N., Jamil, N., Manaf, H. (2016): Postural control and gait performance in the diabetic peripheral neuropathy: a systematic review. – BioMed Research International 15p.

Nakamura, J., Kamiya, H., Haneda, M., Inagaki, N., Tanizawa, Y., Araki, E., Ueki, K., Nakayama, T. (2017): Causes of death in Japanese patients with diabetes based on the results of a survey of 45,708 cases during 2001–2010: Report of the Committee on Causes of Death in Diabetes Mellitus. – Journal of Diabetes Investigation 8(3): 397-410.

Oliveira, P.P.D., Fachin, S.M., Tozatti, J., Ferreira, M.C., Marinheiro, L.P.F. (2012): Comparative analysis of risk for falls in patients with and without type 2 diabetes mellitus. – Revista da Associação Médica Brasileira 58: 234-239.

World Health Organization (WHO) (2021): Diabetes. – WHO Web Portal 5p.

Podsiadlo, D., Richardson, S. (1991): The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. – Journal of the American Geriatrics Society 39(2): 142-148.

Quartuccio, M., Buta, B., Kalyani, R.R. (2017): Comparative effectiveness for glycemic control in older adults with diabetes. – Current Geriatrics Reports 6(3): 175-186.

Rashedi, V., Iranpour, A., Mohseni, M., Borhaninejad, V. (2019): Risk factors for fall in elderly with diabetes mellitus type 2. – Diabetes & Metabolic Syndrome: Clinical Research & Reviews 13(4): 2347-2351.

Sertel, M., Şimşek, T., Yümin, E., Aras, B. (2020): Determination of the validity and reliability of the Turkish version of the self-rated fall risk questionnaire in older individuals. – Physiotherapy Quarterly 28(3): 50-55.

Shah, A.D., Langenberg, C., Rapsomaniki, E., Denaxas, S., Pujades-Rodriguez, M., Gale, C.P., Deanfield, J., Smeeth, L., Timmis, A., Hemingway, H. (2015): Type 2 diabetes and incidence of cardiovascular diseases: a cohort study in 1• 9 million people. – The Lancet Diabetes & Endocrinology 3(2): 105-113.

Sinclair, A.J., Abdelhafiz, A.H., Rodríguez-Mañas, L. (2017): Frailty and sarcopenia-newly emerging and high impact complications of diabetes. – Journal of Diabetes and Its Complications 31(9): 1465-1473.

Sinclair, A., Morley, J. (2013): Frailty and diabetes. – The Lancet 382(9902): 1386-1387.

Sirven, N., Rapp, T. (2017): The cost of frailty in France. – The European Journal of Health Economics 18: 243-253.

Thein, F.S., Li, Y., Nyunt, M.S.Z., Gao, Q., Wee, S.L., Ng, T.P. (2018): Physical frailty and cognitive impairment is associated with diabetes and adversely impact functional status and mortality. – Postgraduate Medicine 130(6): 561-567.

Varan, H.D., Deniz, O., Çöteli, S., Doğrul, R.T., Kizilarslanoğlu, M.C., Göker, B. (2022): Validity and reliability of Fried frailty phenotype in Turkish population. – Turkish Journal of Medical Sciences 52(2): 323-328.

Walston, J., Hadley, E.C., Ferrucci, L., Guralnik, J.M., Newman, A.B., Studenski, S.A., Ershler, W.B., Harris, T., Fried, L.P. (2006): Research agenda for frailty in older adults: toward a better understanding of physiology and etiology: summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults. – Journal of the American Geriatrics Society 54(6): 991-1001.

Yanase, T., Yanagita, I., Muta, K., Nawata, H. (2018): Frailty in elderly diabetes patients. – Endocrine Journal 65(1): 1-11.

Yardley, L., Beyer, N., Hauer, K., Kempen, G., Piot-Ziegler, C., Todd, C. (2005): Development and initial validation of the Falls Efficacy Scale-International (FES-I). – Age and Ageing 34(6): 614-619.

Yoon, J.W., Ha, Y.C., Kim, K.M., Moon, J.H., Choi, S.H., Lim, S., Park, Y.J., Lim, J.Y., Kim, K.W., Park, K.S., Jang, H.C. (2016): Hyperglycemia is associated with impaired muscle quality in older men with diabetes: the Korean Longitudinal Study on Health and Aging. – Diabetes & Metabolism Journal 40(2): 140-146.

Yücel, S.D., Şahin, F., Doğu, B., Şahin, T., Kuran, B., Gürsakal, S. (2012): Reliability and validity of the Turkish version of the Performance-Oriented Mobility Assessment I. – European Review of Aging and Physical Activity 9: 149-159.

Downloads

Published

2024-08-31

Issue

Section

Articles

How to Cite

THE EFFECT OF FRAILTY ON BALANCE AND FALL RISK IN TYPE 2 DIABETIC PATIENTS. (2024). Quantum Journal of Medical and Health Sciences, 3(3), 25-36. https://doi.org/10.55197/bgsttf02