Frailty as a Predictor of Falls in Older Adults with Type 2 Diabetes: Evidence from Vietnam

Frailty and falls significantly impact the health and quality of life of older adults with type 2 diabetes (T2D), increasing morbidity and dependency. However, their association in Vietnamese populations remains understudied. This study aimed to examine the association between frailty and fall risk and identify additional fall-related factors among older Vietnamese outpatients with T2D.

A cross-sectional study was conducted among 740 outpatients with T2D aged ≥60 years at a geriatric hospital in Hanoi, Vietnam, from March 2024 to December 2024. Fall risk was assessed using the 21-item Fall Risk Index (21-FRI), and frailty was determined by the Clinical Frailty Scale (CFS). Four multivariable logistic regression models evaluated frailty's association with falls, adjusting for demographics, diabetes-related factors, and geriatric syndromes.

Among 740 older participants with T2D, 17.8% were frail, and 16.8% reported at least one fall in the past year. Frailty was strongly associated with a higher fall rate (p<0.001). In the fully adjusted logistic regression model, frailty emerged as a powerful and independent predictor of falls, increasing the odds by over four-fold (AOR 4.47, 95% CI 2.00-5.29). Other significant risk factors included advanced age, poor glycemic control, diabetic complications, and co-existing geriatric syndromes (depression, urinary incontinence, cognitive impairment, and sarcopenia).

Routine frailty screening should be integrated into T2D care to identify high-risk older adults and implement tailored fall prevention strategies.