The progressive The ageing of the population is causing the number of fragile people to rise and higher, a reality that creates significant challenges for society and health. Preventing, or at least delaying, the transition from pre-frailty, a condition in which the person is still substantially healthy, to frailty, a state that often results in disability, is therefore of crucial importance. In a letter to the European Journal of Internal Medicine a group of researchers from the University of Campania «Luigi Vanvitelli» and the University of Naples «Federico II» underlines how important the monitoring and control of blood sugar are for this purpose.
In their letter, the researchers present the results of the Monteforte study, designed specifically to assess the impact of hyperglycemia in the transition from pre-frailty to frailty.The study recruited 231 pre-fragile elderly (age> 65 years) assisted by the ASL of Avellino between March and December 2021. Inclusion criteria included a diagnosis of primary hypertension and a Montreal Cognitive Assessment (MoCA) score of less than 26 (the score range for this tool for assessing mild cognitive impairment is 0 to 30, a value greater than 26 is considered normal). The assessment of the state of pre-frailty/frailty was made using Fried’s criteria; The definition of pre-fragile includes a subject who has one or two of the following criteria: weight loss, fatigue, muscle weakness, reduced physical activity, reduced walking speed.
The study authors divided study participants into normoglycemic and hyperglycemic based on baseline blood glucose value. Apart from the levels of the two groups did not show significant differences. After 6 months, the proportion of hyperglycemic patients who developed frailty was significantly higher than that of normoglycemic patients (40.2% versus 12.1%; P<0.001).This finding was confirmed by multivariate regression analysis where follow-up frailty was the dependent variable.
«Our data indicate the importance of hyperglycemia in the onset of frailty and suggest that glycemic control remains a fundamental objective in hypertensive pre-frail elderly with or without diabetes – comment the authors who, after recommending careful clinical evaluation and good geriatric evaluation of the pre-fragile elderly, suggest one of the mechanisms potentially involved in the transition. One of the common features of hypertension and hyperglycemia is endothelial dysfunction, known to increase the risk of oxidative stress, inflammation and atherosclerosis. In this scenario, the transition from pre-frailty to frailty triggered by hyperglycemia in hypertensive elderly could depend on increased endothelial dysfunction.»
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Source — https://www.univadis.it/viewarticle/dalla-pre-fragilit%25C3%25A0-alla-fragilit%25C3%25A0-il-ruolo-2023a10000sp