65 Yaş ve Üzeri Tip 2 Diabetes Mellituslu Bireylerde Kırılganlık ve Kapsamlı Geriatrik Değerlendirme

Abstract

Yıldırım H. Kübra.; Frailty and Comprehensive Geriatric Assessment in Individuals Aged 65 and Over with Type 2 Diabetes Mellitus; Hacettepe University Faculty of Medicine, Department of Internal Diseases Residency Thesis, Ankara, 2023 Diabetes and frailty are two medical conditions that become more prevalent with aging and often coexist. The prognosis and appropriate treatment targets for older adults with diabetes vary significantly depending on the presence and degree of frailty. Older adults living with type 2 Diabetes Mellitus (DM), in particular, are more susceptible to hypoglycemia and are more vulnerable to outcomes such as falls, fractures, hospitalizations, cardiovascular events, and all-cause mortality. The aim of the study is to assess the prevalence of frailty and other geriatric syndromes in older adults living with DM and examine their relationships with diabetes. The study included 373 patients who presented to the outpatient clinic of the Geriatric Department of Hacettepe University Faculty of Medicine Hospital. Comprehensive geriatric assessments were conducted during outpatient clinic visits. Frailty presence was assessed using two different models, Clinical Frailty Scale (CFS) and Fried Physical Frailty Scale (FPFS). Additionally, ultrasound and Bioelectrical Impedance Analysis (BIA) measurements were performed for patients' muscle mass and performance evaluation. Among the evaluated 373 patients, frailty prevalence was determined as 18,2%, and pre-frailty as 56% based on FPFS, while the prevalence was determined as 57,4% according to the CFS. It was demonstrated that geriatric syndromes accompany frailty in diabetic patients and are associated with diabetes duration and hypoglycemia risk. Inappropriate strict glycemic control below recommended glycemic targets was observed in individuals living with frailty. Furthermore, significant correlations were found between USG, BIA parameters and the frailty. As a result of the study, the importance of considering the concept of frailty in the evaluation and determination of treatment goals for older adults with DM in clinical practice was emphasized.