title: Diabetes mellitus, hypertension and frailty: A population-based, cross-sectional study of Mexican older adults.
abstract: OBJECTIVE
  Chronic diseases are frequent in older adults, particularly hypertension and diabetes. The relationship between frailty and these two conditions is still unclear. The aim of the present analyses was to explore the association between frailty with diabetes and hypertension in Mexican older adults.
  
  
  METHODS
  Analyses of the Mexican Health and Nutrition Survey, a cross-sectional survey, are presented. Data on diabetes and hypertension were acquired along with associated conditions (time since diagnosis, pharmacological treatment, among others). A 36-item frailty index was constructed and rescaled to z-values (individual scores minus population mean divided by one standard deviation). Multiple linear regression models were carried out, adjusted for age and sex.
  
  
  RESULTS
  From 7164 older adults, 54.8% were women, and their mean age was 70.6 years with a mean frailty index score of 0.175. The prevalence of diabetes was of 22.2%, and 37.3% for hypertension. An independent association between diabetes, hypertension or both conditions (coefficients 0.28, 0.4 and 0.63, respectively, P < 0.001) with frailty was found. Having any diabetic complication was significantly associated with frailty with a coefficient of 0.55 (95% CI 0.45-0.65, P < 0.001) in the adjusted model. The number of years since diagnosis was also associated with frailty for both conditions.
  
  
  CONCLUSIONS
  Diabetes and hypertension are associated with frailty. In addition, an incremental association was found when both conditions were present or with worse associated features (any complication, more time since diagnosis). Frailty should be of particular concern in populations with a high prevalence of these conditions. Geriatr Gerontol Int 2017; 17: 925-930.
authors.affiliation: Geriatric Epidemiologic Research, National Institute of Geriatrics, Mexico City, Mexico.
authors.forename: Roberto Carlos
authors.initials: RC
authors.lastname: Castrejón-Pérez
authors.affiliation: Geriatric Epidemiologic Research, National Institute of Geriatrics, Mexico City, Mexico.
authors.forename: Luis Miguel
authors.initials: LM
authors.lastname: Gutiérrez-Robledo
authors.affiliation: Gérontopôle, University of Toulouse Hospital Center, Toulouse, France.|University of Toulouse III Paul Sabatier, Toulouse, France.
authors.forename: Matteo
authors.initials: M
authors.lastname: Cesari
authors.affiliation: Geriatric Epidemiologic Research, National Institute of Geriatrics, Mexico City, Mexico.
authors.forename: Mario Ulises
authors.initials: MU
authors.lastname: Pérez-Zepeda
mesh_terms: D000368:Aged; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000150:complications*; D005260:Female; D000073496:Frailty / Q000453:epidemiology*; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000150:complications*; D016014:Linear Models; D008297:Male; D008800:Mexico
keywords: diabetes; frailty; geriatric medicine; hypertension