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Frailty Status and Gait Parameters of Older Women With Type 2 Diabetes
Renata Noce Kirkwood1, Izabela Lara Borém2, Rosana Ferreira Sampaio3
1Graduate Program in Health Science, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil; Graduate Program in Rehabilitation Science, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Objectives:
Gait decline in individuals with frailty status is associated with comorbidities, falls and reduced mobility, reflecting changes in gait. The prevalence of frailty in individuals with type 2 diabetes is higher compared to individuals without diabetes. However, the consequences of frailty status on gait in older women with diabetes are unclear. The objective of the study was to investigate gait changes in older women with diabetes who are classified as vulnerable, having 1 or more frailty conditions, or robust, having none of the conditions, according to the Fried phenotype.
Methods:
Participants included 203 older women: 112 without diabetes and 91 with diabetes. The nondiabetes robust group included 59 older women: nondiabetes, vulnerable, 53; diabetes, robust, 26; and diabetes, vulnerable, 65. Gait parameters were obtained by using the GAITRite system and included velocity, cadence, step length, stance time and double-support time. Multivariate analysis was conducted followed by post hoc analysis.
Results:
Older women with diabetes and vulnerable status used more drugs and had higher body mass indexes than the groups without diabetes who were vulnerable and robust; there was no difference between the diabetes, robust and diabetes, vulnerable groups. Falls history and fear of falling were similar in all groups. Vulnerable older women with diabetes walked with decreased velocity, cadence and step length and increased stance time compared to all groups and with increased double-support time compared to the nondiabetes robust and nondiabetes vulnerable groups.
Conclusions:
Gait decline in vulnerable older women with diabetes is worsened by their frailty status. Our study reinforces the importance of screening older women with diabetes for frailty status.
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