老年糖尿病患者衰弱现况及影响因素分析

目的：调查老年糖尿病患者的衰弱现况，并探讨老年糖尿病患者衰弱的影响因素。方法：采用便利抽样法，选取天津市某三甲医院1007例老年糖尿病患者，采用一般资料调查表、FRAIL衰弱量表、老年抑郁量表、“起立—行走”计时测试、画钟试验、糖尿病自我管理行为量表等进行调查。结果：共回收998份有效问卷。老年糖尿病患者衰弱发生率为8.02%（80/998），衰弱前期发生率为55.31%（552/998），其中疲乏（48.7%）是出现频率最高的衰弱指标。多元Logistic回归分析显示，体重指数、糖尿病并发症数量、糖化血红蛋白水平、慢性疼痛、“起立—行走”时间、抑郁状态是老年糖尿病患者衰弱前期的影响因素（P<0.05），糖尿病并发症数量、糖化血红蛋白水平、慢性疼痛、“起立—行走”时间、间歇性跛行、抑郁状态是老年糖尿病患者衰弱的影响因素（P<0.05）。结论：老年糖尿病患者衰弱及衰弱前期发生率较高，衰弱的发生与患者血糖水平及糖尿病并发症密切相关；医护人员应当高度重视老年糖尿病患者衰弱评估，及时采取针对性干预措施，以预防和延缓衰弱的发生与发展，改善患者健康状况和生活质量。

Analysis on status and influential factors of frailty in elderly patients with diabetes mellitus

Objective:To investigate the status and influential factors of frailty in elderly patients with diabetes mellitus.Methods: Totally 1007 hospitalized elderly patients with diabetes were selected from a tertiary hospital in Tianjin. Patients were investigated by self-designed general information questionnaire, the FRAIL scale, geriatric depression scale 5(GDS-5), timed up and go test (TUGT), clock drawing test (CDT) and the scale of diabetes self-care activities (SDSCA).Results:998 valid questionnaires were collected.The incidence of frailty in elderly diabetic patients was 8.02%(80/998) and 55.31% (552/998) at the early stage of frailty, among which fatigue(48.7%) was the most frequent indicator of frailty. Multivariate Logistic regression analysis showed that the influence factors of frailty in elderly patients with diabetes mellitus included BMI, diabetes complications, glycosylated hemoglobin, chronic pain, TUGT, intermittent claudication, depression(P<0.05).Conclusion:The incidence of frailty and pre-frailty were high in elderly diabetic patients, and frailty was closely related to blood glucose level and diabetic complications.Medical staff should attach great importance to frailty assessment of elderly diabetic patients, take targeted intervention to prevent and delay the development of frailty, so as to improve their quality of life and health condition.