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Associations Between Frailty and the Increased Risk of Adverse Outcomes Among 38,950 UK Biobank Participants With
Xingqi Cao1,2,3, Xueqin Li1,2,3, Jingyun Zhang1,2,3
1Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
JMIR Public Health and Surveillance
|May 18, 2023
Summary
Frailty and prefrailty significantly increase risks for adverse outcomes in adults with prediabetes, including type 2 diabetes and cardiovascular disease. Assessing frailty can help target interventions and manage health risks more effectively.
Area of Science:
- Gerontology and Geriatric Medicine
- Endocrinology and Metabolism
- Public Health and Epidemiology
Background:
- Prediabetes is associated with increased frailty compared to normal glucose metabolism.
- The role of frailty in identifying high-risk individuals with prediabetes for adverse outcomes is not well understood.
Purpose of the Study:
- To systematically evaluate the association between frailty and risks of multiple adverse outcomes in middle-aged adults with prediabetes.
- To assess risks for incident type 2 diabetes mellitus (T2DM), diabetes-related microvascular disease, cardiovascular disease (CVD), chronic kidney disease (CKD), eye disease, dementia, depression, and all-cause mortality.
Main Methods:
- Utilized UK Biobank data from 38,950 middle-aged adults (40-64 years) with prediabetes.
- Assessed frailty using the frailty phenotype (FP) score, categorizing participants as nonfrail, prefrail, or frail.
- Employed Cox proportional hazards regression models for association analysis over a median 12-year follow-up, with sensitivity analyses for robustness.
Main Results:
- Nearly 50% of participants were prefrail (49.1%) and 5.9% were frail at baseline.
- Both prefrailty and frailty were significantly associated with increased risks of multiple adverse outcomes (P for trend <.001).
- Frail participants showed significantly higher risks for T2DM (HR=1.73), microvascular disease (HR=1.89), CVD (HR=1.66), CKD (HR=1.76), eye disease (HR=1.31), dementia (HR=2.03), depression (HR=3.01), and all-cause mortality (HR=1.81) compared to nonfrail individuals.
Conclusions:
- Frailty and prefrailty are significant risk factors for adverse outcomes in middle-aged adults with prediabetes.
- Findings support the integration of frailty assessment into routine care for prediabetes management.
- Frailty assessment can aid in resource allocation and reducing the burden of diabetes-related complications.
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