A Survey Of The Debilitating Status Of The Elderly Diabetes Patients In The Community And STEP Intervention Effect

ObjectiveThe present study aims to investigate the prevalence of frailty in elderly diabetes patients in the community and the influencing factors.According to the results of the questionnaire,we built the STEP version of Home-based exercise program to explore the influence of Home-based exercise intervention on the elderly diabetes patients.Methods(1)A random sample of 343 elderly diabetes patients in four communities from Hengyang were investigated with general information questionnaire,the Tilburg frailty index,depression questionnaire,to explore demographic data,chronic disease and life style of the elderly hypertensive patients and the level of the frailty.(2)Two communities were selected as the intervention group and the control group by lottery fashion.A total of 80 older patients with diabetes patients complicated with frailty were randomly selected from the experimental group(n = 40)and the control group(n = 40).The patients in the experimental group received STEP-based home exercise intervention,while the patients in the control group was still under general health guidance.Before and after intervention of six months,we used the general situation questionnaire and Tilburg frailty index to evaluate physical frailty,psychological frailty and social frailty for two groups,and we also make an assessment on fasting blood glucose,two-hour postprandial blood glucose,BMI index,grip strength score,6-minute walking distance,ADL score.The data of two groups obtained were statistically analyzed by using SPSS22.0 software and Mathlab7.0 software.Description statistics were calculated for means,standard deviations and composition ratio.Statistical analysis was performed by chi-square test,t-test,Mann-Whitney U test,One-way ANOVA test,multiple linear regression analysis and Spearman correlation analysis,?=0.05.Results(1)The total score of frailty was(5.52±3.29),and the percentage of frailty was 57.7%.In particular,the score of physical frailty was(3.00±2.19),the score of physical frailty was(3.00±2.19),and the score of social frailty(0.88±0.8).Spearman correlation analysis showed that depression were positively correlated with frailty(r=0.617,P<0.01).(2)One-way ANOVA test showed that the incidence of frailty in older patients with diabetes mellitus is associated with education level,marital status,drinking status,exercise,cognitive,the number of complications and the number of hospitalization whose differences were statistically significant.The multiple linear regression analysis showed that exercise,cognitive,marital status,the number of hospitalization,education level were the main factors influencing frailty.(3)Before the intervention,the scores of two groups have no significant difference in general demographic data,fasting blood glucose,two-hour postprandial blood glucose,BMI index,grip strength score,6-minute walking distance,ADL,physical frailty,psychological frailty and social frailty(P>0.05).(4)After 6 months of STEP-based home exercise intervention,the two groups had clear difference on the scores of BMI index,grip strength score,6-minute walking distance,ADL,total frailty,physical frailty(P<0.05).Compare with two groups before and after intervention,the intervention group had significant difference on the scores of BMI index,grip strength,6-minute walking distance,ADL,total frailty,physical frailty,psychological frailty and social frailty(P<0.05),while the control group has no clear difference(P>0.05).Conclusion(1)There is a high incidence in older patients with diabetes mellitus in the community,exercise,cognitive,marital status,the number of hospitalization,education level were the main factors influencing frailty.Depression was positively correlated with frailty.(2)The results showed that the STEP version Home-based exercise can effectively improve the frail state of elderly patients with diabetes mellitus in the community.