Frailty Is Associated with an Increased Risk of Incident Type 2 Diabetes in the Elderly.
To investigate whether frailty is associated with an increased risk of incident type 2 diabetes mellitus (T2DM) in a prospective cohort of community-dwelling older people.



Longitudinal study, mean follow-up of 4.4 years.



Progetto Veneto Anziani (Pro.V.A.) study that involved older community-dwellers.



1754 men and women older than 65 years without T2DM at baseline.



Frailty status was defined according to Fried criteria and categorized as frailty (≥3 criteria), prefrailty (1-2 criteria), or no frailty (0 criterion). Incident T2DM was defined as fasting plasma glucose (FPG) ≥7.0 mmol/L, or glycosylated hemoglobin ≥6.5%, the use of glucose-lowering drugs, or FPG ≥11.1 mmol/L on a 2-hour oral glucose tolerance test during the follow-up. All T2DM diagnoses were confirmed by endocrinologists.



At baseline, frail participants (n = 174) were significantly (a) more obese and had higher waist circumference, (b) experienced a higher rate of cardiovascular disease (including hypertension), and (c) presented with higher, but not pathologic, values of glycosylated hemoglobin and FPG than prefrail (n = 830) and nonfrail participants (n = 750). Over a 4.4-year follow-up, 265 individuals developed T2DM. In a logistic regression analysis, adjusted for potential baseline confounders, frailty [odds ratio (OR) = 1.87, 95% confidence interval (CI) = 1.31-2.13, P < .0001] and prefrailty (OR = 1.60, 95% CI = 1.27-2.00, P < .0001) were associated with a significantly higher incidence of T2DM than in nonfrail individuals.



Among community-dwelling older people, frailty and prefrailty were significant and independent predictors of T2DM, which is a major and potentially preventable risk factor for multiple comorbidities.
Geriatrics Division, Department of Medicine-DIMED, University of Padova, Italy; Institute of clinical Research and Education in Medicine (IREM), Padova, Italy. Electronic address: ilmannato@gmail.com.
Nicola
N
Veronese
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Brendon
B
Stubbs
Department of Clinical and Experimental Sciences, Brescia University, Italy; Department of Medicine, Washington University School of Medicine, St Louis, MO, USA; CEINGE Biotecnologie Avanzate, Napoli, Italy.
Luigi
L
Fontana
Geriatrics Division, Department of Medicine-DIMED, University of Padova, Italy.
Caterina
C
Trevisan
Geriatrics Division, Department of Medicine-DIMED, University of Padova, Italy.
Francesco
F
Bolzetta
Geriatrics Division, Department of Medicine-DIMED, University of Padova, Italy.
Marina
M
De Rui
Clinica Medica I, Department of Medicine-DIMED, University of Padova, Italy.
Leonardo
L
Sartori
Clinica Medica I, Department of Medicine-DIMED, University of Padova, Italy.
Estella
E
Musacchio
Department of Medicine, Washington University School of Medicine, St Louis, MO, USA; Neuroscience Institute, National Research Council, Padova, Italy.
Sabina
S
Zambon
Neuroscience Institute, National Research Council, Padova, Italy.
Stefania
S
Maggi
Biostatistics, Epidemiology and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
Egle
E
Perissinotto
Division of Health Care Planning and Evaluation of the Regione Veneto, Venice, Italy.
Maria Chiara
MC
Corti
Neuroscience Institute, National Research Council, Padova, Italy.
Gaetano
G
Crepaldi
Geriatrics Division, Department of Medicine-DIMED, University of Padova, Italy; Neuroscience Institute, National Research Council, Padova, Italy.
Enzo
E
Manzato
Geriatrics Division, Department of Medicine-DIMED, University of Padova, Italy.
Giuseppe
G
Sergi
D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D005260:Female; D016330:Frail Elderly; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D018570:Risk Assessment
Diabetes; community-dwelling adults; elderly; frailty