Abdominal obesity is more closely associated with incidence of frailty than general obesity in the elderly. Older adults with large waist circumference are more likely to be frail. Frailty in the elderly might be more closely related to metabolic disorders. WC might be a better measurement to detect frailty than BMI, given its relationship with metabolic disorders.

Aim: The aim of this study was to investigate the risk factors for cognitive impairment in older people with diabetes. Methods: This cross-sectional study included 2626 community-dwelling participants with diabetes aged ⩾55 years, living in Beijing, China. The participants were screened for risk factors, including smoking, obesity, hypertension, stroke, coronary heart disease, dyslipidemia, depression, apolipoprotein E (APOE) genotype, and low physical activity. Cognitive function was assessed with the scholarship-adjusted Mini-Mental State Examination (MMSE): MMSE ⩽17 for iliterate participants; MMSE ⩽20 for primary school graduates (⩾6 years of education); and MMSE ⩽24 for junior school graduates or above (⩾9 years of education). Results: The prevalence of cognitive impairment in older people with diabetes was 9.90%. Multiple logistic regression analysis demonstrated that stroke [odds ratio (OR) = 1.71, 95% confidence interval (CI) = 1.20–2.43], less than 0.5 h exercise per day (OR = 1.89, 95% CI = 1.37–2.61), and depression (OR = 1.64, 95% CI = 1.06–2.54), but not smoking, obesity, hypertension, dyslipidemia, and coronary heart disease, were independent risks for cognitive impairment in older people with diabetes. In addition, being married (OR = 0.66, 95% CI = 0.47–0.93) and urban living (OR = 0.33, 95% CI = 0.22–0.48) could decrease the risk of cognitive impairment. Conclusions: Stroke, depression, and less than 0.5 h exercise per day were independent risks for cognitive impairment in older people with diabetes, whereas being married and urban living were protective.

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AimThe aim of this study was to investigate whether elderly people with impaired fasting glucose (IFG) or diabetes mellitus (DM) share the common risk factors for cognitive impairment as compared to normal blood glucose population.MethodsThis cross-sectional study assessed 10,039 community-dwelling participants aged ≥ 55 years in Beijing, China. According to the glycemic status, subjects were classified into three groups: normal fasting plasma glucose (NG, n=6399), impaired fasting glucose (IFG, n=873) and DM (n=2626). The Mini-Mental State Examination (MMSE) was applied to evaluate the cognitive function status of the study population. Potential demographic, clinical, and genetic risk factors for cognitive impairment were collected and compared across the three groups. Multivariate logistic regression model was performed to explore the risk factors associated with cognitive impairment.ResultsEducation-modified MMSE scores in the participants with NG, IFG, and DM were 26.91±3.94, 26.67±4.00, and 26.58±4.11, respectively (P=0.0008). In the age- and sex-adjusted comparisons, the MMSE scores in subjects with DM and IFG were significantly lower than that in subjects with normal glucose (P=0.01 and P=0.02, respectively). The logistic regression analysis showed that risk factors only in the NG population were older age, female, apoEε4 carrier, normal or lower uric acid (UA) levels. Hypertension was an independent risk factor only in IFG group, and the history of stroke and depression were the risk factors associated with cognitive impairment only in the DM group.ConclusionSubjects with DM or IFG had a lower performance on the MMSE test compared with subjects who had normal blood glucose. The elderly with diabetes and IFG have some different risk factors for cognitive impairment as compared to those with normal blood glucose.

Background Sarcopenia, an age-related disease, has been implicated as both a cause and consequence of type 2 diabetes mellitus (T2DM) and a symbol of poor prognosis in older adults with T2DM. Therefore, early detection and effective treatment of sarcopenia are particularly important in older adults with T2DM. We aimed to investigate the prevalence of sarcopenia in Chinese older T2DM patients and explore whether homocysteine and inflammatory indexes could serve as biomarkers and participate in the development process of sarcopenia. Methods T2DM patients aged over 60 years were consecutively recruited from the ward of department of Endocrinology, Xuanwu Hospital between April 2017 and April 2019. Sarcopenia was defined based on the standard of the Asian Working Group of Sarcopenia, including muscle mass, grip strength and gait speed. Logistic regression was used to explore the association between biochemical indicators and sarcopenia. Receiver operating characteristic (ROC) curves were applied to determine the diagnostic effect of these clinical indicators. Results Totally 582 older adults with T2DM were characterized and analyzed in the study. Approximately 8.9% of the older T2DM patients had sarcopenia. After adjusting for age, sex, body mass index (BMI) and hemoglobin A1c (HbA1c), increased concentrations of homocysteine [odds ratio (OR): 2.829; 95% confidence interval (CI), 1.064–7.525] and high-sensitive C-reactive protein (hs-CRP) (OR: 1.021; 95% CI, 1.001–1.042) were independent predictors of sarcopenia; but not interleukin-6. The combination of age, sex, BMI and HbA1c provided a discriminatory effect of sarcopenia with an area under the curve (AUC) of 0.856, when homocysteine was added to the model, the value of the ROC curve was further improved, with an AUC of 0.861. Conclusion In the current study, we demonstrated a positive correlation of homocysteine, hs-CRP with sarcopenia in older adults with T2DM and the relationship remained significant even after adjustment for HbA1c. These biomarkers (homocysteine and hs-CRP) may play important roles in the pathological process of sarcopenia.

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Background: Poor nutritional status is associated with osteoporosis. Prealbumin is a more sensitive marker than albumin to assess nutritional status. Therefore, the relationship between serum levels of prealbumin and osteoporosis in older adults with type 2 diabetes mellitus (T2DM) was investigated. Methods: A total of 370 older adults with T2DM were divided into two groups: older adults with osteoporosis ( n = 249) and older adults without osteoporosis ( n = 121). Bone mineral density (BMD) and appendicular skeletal muscle (ASM) were measured by dual-energy X-ray absorptiometry (DEXA). Serum levels of prealbumin, highly sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), 25-hydroxyvitamin D 3 [25(OH) D 3 ] were also tested. Logistic regression analysis was performed to assess the association between prealbumin and osteoporosis. Results: The adults with osteoporosis had lower prealbumin levels than those without osteoporosis (235.40 ± 60.66 versus 261.34 ± 55.28 mg/l, p < 0.001). The proportion of adults with prealbumin levels below the normal range was significantly higher in individuals with osteoporosis compared with those without osteoporosis (16.53% versus 4.42%, respectively). After adjusting for age, sex, body mass index (BMI), anemia, handgrip strength and skeletal muscle index (SMI), logistic regression showed that participants with lower levels of prealbumin had a higher risk of osteoporosis [odds ratio (OR): 3.85; 95% confidence interval (CI): 1.54–6.34; p = 0.004]. Conclusion: Our findings suggested that low levels of prealbumin were associated with an increased risk of osteoporosis in older adults with T2DM. Further longitudinal studies should be conducted to determine if there is a causative association between prealbumin and osteoporosis.