Factors Associated with Frailty in Community-Dwelling Older Women with Diabetes : A Secondary Analysis of the 2023 National Survey of Older Koreans

Abstract

This study aimed to examine the distribution of frailty levels, to compare physical function, nutritional status, cognitive function, and depressive symptoms according to frailty level, and to identify factors associated with frailty among community-dwelling older women with diabetes. This was a cross-sectional secondary analysis of the 2023 National Survey of Older Koreans, and 1,368 older women diagnosed with diabetes were analyzed. The main variables were frailty(K-FRAIL), physical function, nutritional status, cognitive function, and depressive symptoms. Data were analyzed using chi-square tests, post-hoc analysis based on adjusted standardized residuals, and multiple logistic regression with IBM SPSS Statistics 32.0. Frailty level was classified as robust in 292 participants(21.3%), pre-frail in 799(58.5%), and frail in 277(20.2%), and all main variables differed significantly by frailty level. In the multivariable logistic regression analysis with frailty status as the dependent variable, the adjusted odds ratios(aORs) for frailty increased progressively across lower quartiles of physical function compared with the fourth quartile: 6.76 for the third quartile, 14.30 for the second quartile, and 18.21 for the first quartile. The adjusted odds of frailty were also significantly higher among participants at moderate(aOR=1.84) or high(aOR=2.72) nutritional risk and among those with severe cognitive impairment (aOR=1.85) or severe depressive symptoms(aOR=2.05; all p<.05). Frailty among older women with diabetes was associated with physical function, nutritional status, cognitive function, and depressive symptoms. Integrated nursing interventions encompassing these domains and community-based early screening of high-risk groups are warranted.