Carga de fragilidade em idosos com Diabetes Mellitus tipo 2 e fatores relacionados

Abstract

Introduction: Chronic Noncommunicable Diseases (DCNT) are the main cause of loss of quality of life in the elderly and entail important functional limitations. Diabetes mellitus type 2 (DM2) is characterized by hyperglycemia affecting organs and systems, and Fragility Syndrome (SF), due to the sarcopenia process concomitant with neuroendocrine and immunological dysregulation in the elderly. Both conditions are listed in the health sciences by the high prevalence and associated comorbidities. In order to evaluate the fragility syndrome, the fragility load is an elementary measure, being considered more current than the evaluation of the phenotype and its characteristics can be associated with some variables found in the elderly with DM2. Objective: To determine the sociodemographic, clinical-functional and depressive symptoms related to the frailty burden in the elderly with type 2 Diabetes Mellitus. Methodology: This is an observational, analytical cross-sectional study conducted in Natal/RN. Elderly patients aged ≥ 60 years diagnosed with T2DM, with independent ambulation and not amputated participated. They were evaluated for socio-demographic data, clinical-functional, depressive symptoms and fragility phenotype. Descriptive statistics and the chi-square test were performed, followed by multivariate logistic regression analysis (p<0,05 and 95% CI). Results: The sample consisted of 125 elderly, mostly female (36,8%), overweight (62,4%), five or more diseases (65,6%) and depressive symptoms (53,2%), reaching a mean of 68,76 (± 6,52) years old. The group with the lowest fragility burden prevailed (56,0%) and the low level of physical activity was the most cited phenotype item (72,0%). The final regression model showed that the fragility burden was significantly associated with age (p=0,016; [1,316-8,794]), schooling (p=0,002; [1,680-10,623]), lower limb pain (p<0.001; [1,935-11,766]) and TUGT (p=0.031; [1,145-15,659]) and this multivariate model presented 80,9% accuracy. Conclusion: the elderly with DM2 that present greater fragility load are of the age group of 70 years or more, are overweight, use 5 or more medications, with a diagnosis time of 6 years or more, with glycated hemoglobin and fasting glycemia altered, with increased walking time and depressive symptoms. On the other hand, the elderly with less frailty showed less schooling, income and cognition.