Identification of Frailty Subtypes in African American Adults With and Without Type 2 Diabetes: A Latent Class...

To identify frailty subtypes among African American adults with and without diabetes.

This analysis included data from 3979 African American men and women who enrolled in the Jackson Heart Study at baseline (Exam1: 2000-2004). To identify frailty subtypes, we selected 25 age-related deficits in health and functional outcomes as indicator variables to use in multiple-group latent class analysis (LCA), with diabetes status as the grouping variable. Components included markers of general health, physical function, social engagement, work, activities of daily living, behaviour/lifestyle, sleep, age-related chronic diseases, pain, clinical biomarkers, and sensorineural abilities.

Three frailty groups were identified for adults with and without diabetes: the 'severely frail' group (15.2% of those without diabetes; 22.4% of those with diabetes); the 'moderately frail' group (21.7% of those without diabetes; 13.1% of those with diabetes); and the 'not frail' group (63.1% of those without diabetes; 64.5% of those with diabetes). Adults in the 'severely frail' group had higher probabilities of poor health perception, limited mobility, high blood pressure, obesity, and claudication, and this was similar for those with and without diabetes. Among individuals in the 'moderately frail' group, higher probabilities of poor health perception, limited mobility, high blood pressure, obesity, and claudication were found among those with diabetes, whereas only sleep quality and obesity had higher probabilities among those without diabetes.

Three heterogeneous frailty subgroups were identified among African American adults, with similarities and differences noted for those with and without diabetes with regard to high probabilities for certain deficits in health and functional outcomes. Further investigation is needed to evaluate if these subgroups predict health-related outcomes.