Investigation Of Geriatric Syndrome In Patients With Diabetes Mellitus In Tianjin Community

Objective Geriatric syndrome is a series of non-specific symptoms and signs in elderly people with increasing age and the gradual failure of organ systems,these health problems seriously affect the quality of life and significantly shortened life expectancy for the elderly.Different from traditional syndromes or diseases in the clinical medicine,more emphasis on that is a common clinical feature after multiple causes,a geriatric syndrome often involves multiple risk factors and organ systems damage.Diabetes is a lifelong chronic noncommunicable disease,as age-related diseases,diabetes is more common in the elderly,at the same time diabetes is a risk factors to geriatric syndrome,so the elderly diabetes patients is occurred at higher risk of geriatric syndrome.Geriatric syndrome will not only cause debilitating,disability,decreased quality of life,at the same time increased the difficulty of the diabetes management,reduces the treatment compliance,at present research at home and abroad had more concentrated on diabetes patients in hospitalized.The purpose of this study is to investigate the prevalence of geriatric syndromes in elderly patients with diabetes mellitus in the community and provide guidance for rational intervention and management.Methods The elderly at an age of over 60 years 1248 subjects accepting regular physical examination in Quanyechang street community of Tianjin from July 2016 to January 2017 were enrolled to receive a routine physical examination and integrated assessment of geriatric syndromes.The investigator completed the record of the physical examination information and assessment by using the self-made structure questionnaire.A total of 1188 subjects were included in the study,including 503 males and 685 females.According to the diagnostic criteria of the WHO,FPG is more than 7mmol/L,followed by another day,or with a clear history of diabetes.The subjects were divided into diabetes group(n=415)and non-diabetic group(n=773).The patients with diabetes were divided into a group of patients with a disease duration of more than 10 years(n=179)and the course of disease <10 years(n=236).According to the number of diabetes comorbidities object can be divided into single diabetes(n=61),the combining 1(n=104),2(n=130),3(n=79),the combining 4 and above 5 groups(n=41).191 patients with previous history of diabetes were tested for Hb Alc,According to the Hb Alc level,the patients with diabetes were divided into the Hb Alc≥7.5% group(n=67)and the Hb Alc<7.5% group(n=124).Compare every groups of geriatric syndrome,analysis the relationship between geriatric syndrome and diabetes course,blood glucose control level and comorbidities.Results The average age of the object was(73.7±7.6)years,the prevalent of hearing impairment,vision disorder,sleep disorder,chronic pains,urinary incontinence,malnutrition,depression,poly pharmacy and impairment of activity of daily living was 32.2%,87.7%,31.0%,71.0%,6.4%,22.4%,8.4%,12.5%,12.8%.98.3% of the diabetes had at least one geriatric syndromes,The risk of disability [(15.7%)vs(11.3%)],depression [(11.1%)vs(7.0%)] and polypharmacy [(24.1%)vs(6.3%)] in patient with diabetes mellitus was significantly higher than that in non-diabetes mellitus.The incidence of geriatric syndrome was higher in the patients with longer disease course [(course≥10years)vs(course<10years)].When compared with the well-controlled diabetic patients(Hb A1c<7.5%),the poor-controlled patients(Hb A1c≥7.5%)were found to have higher risk rate of disability[(17.9%)vs(8.1%)] and depression[(16.4%)vs(7.3%)].85.3% had different comorbidities in 415 cases of elderly diabetes patients,The increase in the number of diabetic comorbidities significantly increased the incidence of geriatric syndrome expect for vision disorder(p=0.513)and polypharmacy(p=0.086).Conclusion The risk of disability,depression and polypharmacy in patient with diabetes mellitus was significantly higher than that in non-diabetes,The incidence of geriatric syndrome was higher in the patients with longer disease course and more complications,The level of blood glucose control affects the prevalent of disability and depression.Comprehensive geriatric assessment is important to the diabetic for the management and the improvement of quality of life in the community.