title: Hypoglycemia is independently associated with multidimensional impairment in elderly diabetic patients.
abstract: OBJECTIVE
  To identify the characteristics associated with multidimensional impairment, evaluated through the Multidimensional Prognostic Index (MPI), a validated predictive tool for mortality derived from a standardized Comprehensive Geriatric Assessment (CGA), in a cohort of elderly diabetic patients treated with oral hypoglycemic drugs.
  
  
  RESULTS
  The study population consisted of 1342 diabetic patients consecutively enrolled in 57 diabetes centers distributed throughout Italy, within the Metabolic Study. Inclusion criteria were diagnosis of type 2 diabetes mellitus (DM), 65 years old or over, and treatment with oral antidiabetic medications. Data concerning DM duration, medications for DM taken during the 3-month period before inclusion in the study, number of hypoglycemic events, and complications of DM were collected. Multidimensional impairment was assessed using the MPI evaluating functional, cognitive, and nutritional status; risk of pressure sores; comorbidity; number of drugs taken; and cohabitation status. The mean age of participants was 73.3 ± 5.5 years, and the mean MPI score was 0.22 ± 0.13. Multivariate analysis showed that advanced age, female gender, hypoglycemic events, and hospitalization for glycemic decompensation were independently associated with a worse MPI score.
  
  
  CONCLUSIONS
  Stratification of elderly diabetic patients using the MPI might help to identify those patients at highest risk who need better-tailored treatment.
authors.affiliation: Geriatrics Unit, Azienda ULSS 16, S. Antonio Hospital, 35127 Padua, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Pilotto
authors.affiliation: CNR-Institute of Neuroscience, Aging Branch, Via Giustiniani 2, 35128 Padua, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Noale
authors.affiliation: CNR-Institute of Neuroscience, Aging Branch, Via Giustiniani 2, 35128 Padua, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Maggi
authors.affiliation: Geriatrics Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, 71013 Foggia, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Addante
authors.affiliation: Department of Medicine, University of Padua, 35128 Padua, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Tiengo
authors.affiliation: Diabetology Unit, University of Turin, 10124 Turin, Italy.
authors.forename: P Cavallo
authors.initials: PC
authors.lastname: Perin
authors.affiliation: Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme, 82037 Benevento, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Rengo
authors.affiliation: CNR-Institute of Neuroscience, Aging Branch, Via Giustiniani 2, 35128 Padua, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Crepaldi
mesh_terms: D000368:Aged; D003710:Demography; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007003:Hypoglycemia / Q000150:complications*; D008297:Male; D012307:Risk Factors