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

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.

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.

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.

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. Competing Interest Statement The authors have declared no competing interest. Funding Statement This study did not receive any funding Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The studies were approved by the Ethics Committee of the University of Medicine and Pharmacy at Ho Chi Minh City (Reference Number 934/DHYD-HDDD, dated 24/11/2022). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All data produced in the present study are available upon reasonable request to the authors