Racial/ethnic minorities with diabetes have increased risk of complications. Frailty, an indicator of increased vulnerability to adverse health outcomes is associated with dependency and disability. The aim of this study was to examine the association between frailty and clinical outcomes (blood pressure (BP) , hemoglobinA1C (HbA1C) , low-density lipoprotein (LDL)) and whether associations differ by race/ethnicity among adults with diabetes. Data on 3792 adults with diabetes from NHANES (2003-2005) were analyzed. Frailty index composed of 46 variables (comorbidities, disability, symptoms, labs, general health) was created ranging from 0 - 1 (frail>=0.21; not frail<0.21) . Linear regression models were used to assess the association between clinical outcomes and frailty. Models were adjusted for age, sex, education, income-to-poverty ratio, marry, insurance, employment, smoke, physical activity, and body mass index; and were stratified by race/ethnicity. Unadjusted models showed an association between systolic BP (SBP) and frailty with those who were frail having significantly higher SBP (NHW: b 19.6; 95%CI:2.5,26.2; non-Hispanic Black (NHB) : b 6.22; 95%CI:0.95,11.5; Hispanic/Other (H/O) : b 13.5;95%CI:7.7, 19.3) ; significantly lower diastolic BP (DBP) for H/O (b -5.5;95%CI:-8.9,-2.1) , and significantly lower HbA1c for NHW (b -0.60;95%CI:-0.99,-0.20) compared to not frail. In adjusted models, frailty was associated with lower DBP for H/O (b -9.8; 95%CI:-17.8,-1.8) , higher LDL for H/O (b 154;95%CI:97.5,210.6) , and higher HbA1C for NHWs (b 0.91;95%CI:0.004,1.8) and NHBs (b 2.5;95%CI:0.97,4.0) . Associations between frailty and clinical outcomes differed by race/ethnicity among adults with diabetes. Frailty should be assessed as part of routine care for patients with diabetes and interventions accounting for limitations and cultural differences of diverse groups of frail adults with diabetes should be developed to improve clinical outcomes.
A.Z.Dawson: None. R.J.Walker: None. J.A.Campbell: None. L.E.Egede: None.
American Diabetes Association (1-19-JDF-075) ; National Institute of Diabetes and Digestive and Kidney Diseases (grant K24DK093699, R01DK118038, R01DK120861, Principal Investigator (PI) : Leonard Egede, MD) National Institute on Minority Health and Health Disparities (R01MD013826, PI: Egede/Walker)