Multimorbidity burden and frailty profile in older outpatients with diabetes: a cross-sectional study

Abstract

Type 2 diabetes mellitus is extremely frequent in older patients. The coexistence of multimorbidity and frailty may bear a significant impact on the management of this condition. Aim of this study was to describe the clinical profile, including the frailty status, in an outpatient population of elderly subjects with respect to diabetes. Data were collected within a cross-sectional retrospective design from the Cardiogeriatrics Clinic of the University Hospital of Baggiovara-Modena, Italy in the period 2010–2025. The population included 1402 subjects without diabetes (42.1% males) and 309 patients with diabetes (55.7% males). Clinical history and physical examination were recorded. Data in non-diabetic and diabetic populations were compared and, in a subgroup of 219 patients, performance status tests and multivariate analysis were performed. At univariate analysis diabetic patients showed a higher prevalence of hypertension (81.88% vs. 69.50%, p < 0.001), coronary heart disease (33.98% vs. 23.63%, p < 0.001), and Parkinson’s disease (5.19% vs. 2.36%, p = 0.007), as well as ECG signs of inferior ischemia (8.20% vs. 4.62%, p = 0.011) and left anterior hemiblock (11.48% vs. 7.65%, p = 0.029). The timed up and go and the standing balance tests were significantly different in non-diabetics vs. diabetics (respectively, 8.40 [7.05–10.08], median [IQR], vs. 9.59 [7.81–11.52], p = 0.025 and 4.00 [4.00–4.00] vs. 4.00 [3.00–4.00], p = 0.009). At multivariate analysis, diabetes was significantly associated with a pre-frailty or frailty status (p = 0.006). In a population of non-hospitalized subjects, the presence of diabetes was significantly associated with a multimorbidity and frailty profile. The use of simple clinical tools may help to define the frailty status and orient the clinical management in this condition.