Analysis Of The Status,influencing Factors And Mediating Effects Of Cognitive Frailty In Elderly Patients With Diabetes Mellitus

Objective:To investigate the current status,influencing factors and mediating effects of cognitive frailty in elderly patients with diabetes mellitus.Methods: A cross-sectional survey was conducted in patients with diabetes mellitus over 65 years old in the Second Xiangya Hospital of Central South University.The survey tools included general information,Fried frailty phenotype,Montreal Cognitive Assessment,Short Physical Performance Battery,Mini-Nutrition Assessment,Simplified Geriatric Depression Scale,the Simple Loneliness Scale,and the Social Frailty Scale.Results: Among the 154 hospitalized elderly diabetic patients,34(22.1%)were cognitive frailty.The results of univariate analysis showed that education level,residence,type of medical insurance,short physical performance battery,nutritional status,social frailty,loneliness,depression,falls,exercise,hypoglycemic program,hemoglobin,serum albumin,serum calcium were associated with cognitive frailty(P<0.05).Multivariate Logistic regression analysis showed that depression(OR=1.210,95%CI 1.022～1.432,P<0.05),falls(OR=7.332,95%CI2.077～25.886,P<0.05)were positively correlated with cognitive frailty in hospitalized elderly diabetic patients,and medical insurance payment(OR=0.263,95%CI 0.088～0.783,P<0.05),short physical performance battery(OR=0.724,95%CI 0.606～0.866,P<0.05)and nutritional status(OR=0.772,95%CI 0.620～0.961,P<0.05)were negatively correlated with cognitive frailty in hospitalized elderly diabetic patients.The mediating effect of depression between nutrition and cognitive frailty was30.8%,and the mediating effect of social frailty between physical condition and cognitive frailty was 21.8%.Conclusions: The prevalence of cognitive frailty in hospitalized elderly diabetic patients is high.Medical insurance payment,short physical performance battery,nutritional status,depression,and falls are independent correlated with cognitive frailty in hospitalized elderly diabetic patients.Depression and social frailty play a mediating role in cognitive frailty.Realizing universal medical insurance,enhancing physical function,improving nutritional status,improving mental health,and preventing falls are effective ways to improve the cognitive frailty and quality of life of elderly diabetic patients.