Fatores relacionados ao prejuízo do controle postural em idosos com Diabetes Mellitus Tipo 2

Abstract

Introduction: Diabetes Mellitus (DM) has been a risk factor for falls and its aggravations, due to the functional abnormalities of the sensorial, motor and autonomic systems, which are exposed to the lack of control of the carbohydrate metabolism, compromising the Postural Control (PC). To identify the clinical, functional and psycho-cognitive factors that are associated with the decline of PC in the elderly with type-2 DM (DM2). Objectives: To identify the clinical, functional and psycho-cognitive factors that are associated with the decline of PC in the elderly with type-2 DM (DM2). Method: This is an observational, cross-sectional, observational study in which 90 male and female individuals, aged 60 years or over were evaluated. The elderly were also evaluated through the Mini BESTest, Mini Mental State Test, Geriatric Depression Scale and WHODAS instruments. The Mann-Whitney tests, from Kruskal-Wallis followed by the Tukey's test and the Spearman's Correlation Coefficient (ρ), p <0.05, were applied. Results: The sample showed a female msjority (65.6%), with a mean age of 68.6 ± 7.5 years. Most of the elderly reported having been diagnosed with DM more than ten years ago (51.2%). The average of Mini BESTest was (74.3%), the worst performing session was Postural Responses (57.1%), while Sensory Orientation achieved the best performance (89.8%). There were significant associations between the total score of the Mini BESTest and the categories of variables: age range (p <0.001), regular physical activity (P = 0.021), pain in the lower limbs (p = 0.019), falls in the last year (p = 0.001), fear of falls (p = 0.006), P = 0.035), tendency to falls (p = 0.012), mobility and risk of falls (p <0.001), complaint of dizziness (p = 0.008) and depressive symptoms (p = 0.001). Significant correlations were found between the Mini BESTest score and the quantitative variables: age (ρ = -0.391, p <0.001), number of diseases (ρ = -0.278, p = 0.031), pain in MMII (ρ = -0.279; (P = 0.008), palmar grip strength (ρ = 0.227, p = 0.033), Mini Mental State Examination (ρ = -0.295, p = 0.005), Geriatric Depression Scale (ρ = -0.389, p <0.001) and Functional Performance (ρ = -0.504, p <0.001). Conclusions: The PC of elderly with type-2 diabetes mellitus is more compromised, is important to prevent the disease. The elderly need guidance on DM2 so that they have a better quality of life.