Frailty and diabetes among Mexican American older adults

Ann Epidemiol. 2018 Jul;28(7):421-426.e1. doi: 10.1016/j.annepidem.2018.04.009. Epub 2018 Apr 26.


Purpose: Progressive physical frailty in older adults is associated with increased risk of falls, disability, institutionalization, and mortality. Although associations between diabetes and frailty have been observed, the impact of diabetes on frailty in older Hispanics is largely unexplored. We examine the association of diabetes on the odds of frailty among older Mexican Americans.

Methods: Using data from the Hispanic Established Population for the Epidemiological Study of the Elderly from 1995 until 2012, frailty was assessed by slow gait, weak hand grip strength, exhaustion, and unexplained weight loss (n = 1327).

Results: Logistic regression showed a large magnitude of effect of diabetes on the odds of frailty (odds ratio 1.47, 95% confidence interval 1.14-1.90). Other contributors to frailty included arthritis, heart attack, and hip fracture. Positive and negative effects had significant and opposing associations. Ordinal logit models assessed the odds of frail compared to nonfrail and prefrail. In these models, diabetes was associated with a 32% increase in the odds of a higher level of frailty.

Conclusions: Diabetes is a significant contributor to increased frailty in older Mexican Americans. Interventions to reduce frailty rates should focus on mitigating the effects of diabetes and shifting away from negative and toward positive effect.

Keywords: Diabetes; Frail elderly; Mexican Americans.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Diabetes Complications / epidemiology
  • Diabetes Complications / ethnology*
  • Diabetes Mellitus / ethnology*
  • Female
  • Frail Elderly*
  • Frailty / complications
  • Frailty / ethnology*
  • Geriatric Assessment
  • Hand Strength
  • Humans
  • Longitudinal Studies
  • Male
  • Mexican Americans / statistics & numerical data*
  • Mexico / ethnology
  • Population Surveillance
  • United States / epidemiology