Sarcopenia increases the odds of frailty in older hospitalized diabetic patients

To determine whether frailty likelihood in diabetes patients is elevated by sarcopenia and to evaluate how its constituent elements, differentially modify this association.

A total of 416 hospitalized patients were grouped as follows: diabetes with sarcopenia (DS), diabetes without sarcopenia (DM), and non-diabetic non-sarcopenic (NDNS). Data on demographics, muscle-related parameters, and dietary intake were collected. Frailty was evaluated using the FRAIL scale. Multivariate logistic regression identified factors associated with frailty, with interaction terms and mediation analysis used to assess the combined effects of diabetes and each sarcopenia component.

The prevalence of frailty was significantly greater in the DS group (38.46%) than in the DM (25.81%) and NDNS (24.61%) groups. After adjusting for confounders, the odds of frailty were 1.35 times greater in the DM group and 3.05 times greater in the DS group than in the NDNS group (OR = 1.35, 95% CI: 1.15-1.58; OR = 3.05, 95% CI: 1.32-7.03). Mediation analysis revealed that low muscle mass was a significant mediator in the diabetes-frailty continuum. Moreover, significant synergistic interactions were observed between diabetes and functional components (low muscle strength, and poor physical performance), further increasing the odds of frailty.

In conclusion, diabetes independently increases the risk of frailty. This relationship is not only mediated by low muscle mass but also synergistically amplified by interactions with poor muscle strength and physical performance. Routine assessment and early intervention targeting these distinct associations are crucial for mitigating frailty.