老年综合征对老年2型糖尿病患者的躯体功能和跌倒风险的影响

Effect of geriatric syndrome on physical function and fall risk in elderly patients with type-2 diabetes

目的探讨老年综合征对老年2型糖尿病患者的躯体功能以及跌倒风险的影响。方法选取2019年2月—2020年2月在浙江医院门诊就诊和住院治疗的老年2型糖尿病患者165例为研究对象,根据患者老年综合征的种类和数量分为0~1种组(36例)、2~3种组(73例)、4~6种组(56例)。比较和分析老年综合征对老年2型糖尿病患者的躯体功能以及跌倒风险的影响。结果4~6种组年龄、离异/丧偶比例、害怕跌倒比例、辅具使用率、近1年出现跌倒史发生率、跌倒高风险率以及日常生活能力缺陷和平衡步态功能下降的比例均明显高于0~1种组和2~3种组患者(均P<0.05);经单因素及多因素logistic回归分析显示衰弱是老年2型糖尿病患者日常生活能力缺陷、平衡与步态功能下降、近1年出现跌倒的独危险因素(均P<0.01);认知功能下降是跌倒风险增高、平衡与步态功能下降、近1年出现跌倒的独立危险因素(均P<0.01);营养不良是日常生活能力缺陷、跌倒风险增高、平衡与步态功能降低、近1年出现跌倒的独立危险因素(均P<0.01)。结论衰弱、营养不良以及认知功能下降等老年综合征会引起老年2型糖尿病患者躯体功能下降和跌倒风险增高,临床应对老年2型糖尿病患者进行老年综合评估并采取干预措施以提高其生活质量。

Objective To investigate the effects of geriatric syndrome on the physical function and the risk of fall in elderly patients with type-2 diabetes.Methods A total of 165 elderly patients with type-2 diabetes who were treated or hospitalised in our hospital from February 2019 to February 2020 were selected as the research subjects.According to the type and quantity of geriatric syndrome,the patients were divided into 0-1 type group(n=36),2-3 type group(n=73),and 4-6 type group(n=56).The effects of geriatric syndrome on physical function and fall risk in elderly patients with type-2 diabetes were compared and analysed.Results The proportion of age,proportion of divorce/widowed,proportion of fear of falling,use rate of assistive devices,incidence of falling history in the past 1 year,incidence of high risk of falling,impairment of daily living and decline of balance gait in 4-6 groups were significantly higher than those in 0-1 group and 2-3 group(all P<0.05).Univariate and multivariate logistic regression analysis showed that fattening was the only risk factor for impairment of daily living ability,decline in balance and gait function,and fall in recent 1 year in elderly patients with type 2 diabetes(all P<0.01).Cognitive decline was an independent risk factor for increased risk of fall,decreased balance and gait function,and the occurrence of fall in the past 1 year(all P<0.01).Malnutrition was an independent risk factor for daily living impairment,increased risk of falls,reduced balance and gait function,and falls in the past 1 year(all P<0.01).Conclusion Geriatric syndromes such as frailty,malnutrition,and cognitive decline,can lead to decreased physical function and increased fall risk in elderly patients with type-2 diabetes.Comprehensive geriatric assessment and intervention measures should be taken to improve the quality of life of elderly patients with this disease.