Frailty and hospitalization in older adults with type 2 diabetes in Vietnam: a focus on sex disparities

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Abstract

Background

Older adults with diabetes often face multiple health challenges such as frailty. Frailty has been reported to be more common and severe in women than men, potentially due to a combination of biological, social and environmental factors. These sex-related differences in frailty may influence health outcomes, such as hospitalization rates.

Aim

This study sought to examine the prevalence of frailty in older adults with type 2 diabetes in an older population in Vietnam, and the association between frailty and hospitalizations, with a focus on sex disparities.

Method

An observational cohort study was conducted at two tertiary hospitals in Vietnam from November 2022 to June 2023. Patients aged 60 years or above with type 2 diabetes that visited the cardio-metabolic clinics during the study period were recruited. Frailty was measured using Fried’s frailty criteria. Logistic regression models were applied to examine the association between frailty and all-cause hospitalization over 6 months. Ratios of odds ratios (ORs) were computed to quantify the sex difference.

Results

There were 644 participants, with a mean age of 71.8 years (SD 7.6), and 30.0% were classified as frail. The prevalence of frailty in women was higher compared to men (31.3% vs 28.8%, p<0.001). The adjusted ORs of frailty on 6-month all-cause hospitalization were 2.71 (1.07 – 6.82) in women, and 1.92 (0.78 – 4.75) in men.

Conclusion

In this study, frailty was more prevalent in women and was associated with an increased risk of hospitalizations in women than in men. This study adds to the understanding of how frailty and sex influence health outcomes in older adults with diabetes, implying the need for sex-specific approaches in managing diabetes in older adults.

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