Vol.:(0123456789) 1 3 Aging Clinical and Experimental Research https://doi.org/10.1007/s40520-017-0852-2 ORIGINAL ARTICLE Frailty, diabetes, and the convergence of chronic disease in an age- related condition: a population-based nationwide cross-sectional analysis of the Mexican nutrition and health survey Roberto C. Castrejón‑Pérez 1  · Carlos A. Aguilar‑Salinas 2  · Luis M. Gutiérrez‑Robledo 1  · Matteo Cesari 3,4  · Mario U. Pérez‑Zepeda 1 Received: 2 June 2017 / Accepted: 4 November 2017 © Springer International Publishing AG, part of Springer Nature 2017 Abstract Aims To describe the associations of frailty with diabetes mellitus and related conditions in older adults. Methods We conducted a cross-sectional analysis of a representative sample of older adults (n = 5379). We generated a 35-item frailty index (FI) and obtained information on diabetes and related conditions (peripheral neuropathy, lower limb amputation, diabetic coma, number of physician visits due to diabetes-related conditions, all-cause hospitalizations in the past year, years since diabetes diagnosis, and type of treatment). Logistic and Poisson regression models were used to determine the associations between frailty and diabetes and its complications. Results The mean age was 70.3 years (± 7.8); 54.7% were women. Those with an FI ≤ 0.082 composed the reference group. Multivariate analysis showed an OR of 2.32 (95% CI 1.93–2.73, p < 0.001) for the association between diabetes and frailty. People who were hospitalized for any cause during the previous year, those receiving both insulin and an oral compound to manage diabetes, and those with peripheral neuropathy showed ORs of 2.32 (95% CI 1.69–3.18, p < 0.001), 5.6 (95% CI 1.58–19.8, p = 0.008), and 2.02 (95% CI 1.42–2.86, p < 0.001), respectively, for being in the most frail group. Conclusions People with diabetes have higher frailty scores. Furthermore, older adults with diabetes and higher burden of frailty have more diabetes-related complications. Keywords Aging · Chronic disease epidemiology · Geriatric endocrinology · Geriatrics · Late complications · Minorities Abbreviations FI Frailty index ENSANUT Encuesta Nacional de Salud y Nutrición SD Standard deviation IQR Interquartile range Introduction Frailty is defined as a physiological state of increased vul- nerability to internal and external stressors, and is closely related to aging [1–3]. However, the earliest stages of this condition may not always be clinically evident. In fact, the biological, clinical, functional, and behavioral manifesta- tions of frailty often occur only after the person-specific threshold of resilience has been surpassed [1, 4, 5]. The lack of a clear etiology and the absence of early markers of frailty make its characterization difficult in the clinical setting [6, 7]. These limitations can lead to unmet clinical needs, which potentially generate a wide spectrum of deleterious Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40520-017-0852-2) contains supplementary material, which is available to authorized users. * Mario U. Pérez-Zepeda ulises.perez@salud.gob.mx; mperez@inger.gob.mx 1 Geriatric Epidemiology Research Department, National Institute of Geriatrics, Periférico Sur 2767, Colonia San Jerónimo Lídice, Delegación Magdalena Contreras, C.P. 10200 Mexico City, Mexico 2 Diabetes Clinic, Endocrinology Department, Nutritional and Medical Sciences Institute “Salvador Zubirán”, Avenida Vasco de Quiroga No.15, Colonia Belisario Domínguez Sección XVI, Delegación Tlalpan, Mexico City C.P.14080, Mexico 3 Geriatric Unit, Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Milan, Italy 4 Department of Medical Sciences and Community Health, University of Milan, Milan, Italy