Falls and Balance Impairments in Older Adults with Type 2 Diabetes: Thinking Beyond Diabetic Peripheral Neuropathy
Falls and Balance Impairments in Older Adults with Type 2 Diabetes: Thinking Beyond Diabetic Peripheral Neuropathy
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DOI：
10.1016/j.jcjd.2015.08.005
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发表时间：
2016-02-01
影响因子：
2.5
通讯作者：
Deshpande, Nandini
中科院分区：
文献类型：
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作者：
Hewston, Patricia;Deshpande, Nandini
患有2型糖尿病的老年人的福尔斯发生率明显高于未患2型糖尿病的老年人。福尔斯的破坏性后果包括行动能力下降、活动回避、机构化和死亡率。与福尔斯相关的最常见的风险因素之一是平衡受损。老年2型糖尿病患者的平衡障碍和随后的跌倒风险增加最常与糖尿病周围神经病变（DPN）相关。因此，DPN已成为老年2型糖尿病患者福尔斯预防研究和干预措施的中心焦点。然而，孤立的研究已经确定没有明显DPN并发症的2型糖尿病成人也有增加的跌倒风险。众所周知，保持平衡的能力是一项复杂的技能，需要整合多种感觉运动和认知过程。新出现的证据表明，与糖尿病相关的感觉功能（体感，视觉和前庭），代谢肌肉功能和执行功能的细微下降也可能导致2型糖尿病老年人跌倒风险增加。了解这些2型糖尿病相关的感觉运动和认知缺陷可能有助于拓宽2型糖尿病老年人预防福尔斯跌倒的方法。因此，这篇小型综述的目的是描述2型糖尿病对感觉运动和认知系统的影响，这些影响可能导致2型糖尿病老年人跌倒风险增加。(C)2015年加拿大糖尿病协会。爱思唯尔公司出版All rights reserved.
Older adults with type 2 diabetes have significantly higher incidence of falls than those without type 2 diabetes. The devastating consequences of falls include declines in mobility, activity avoidance, institutionalization and mortality. One of the most commonly identified risk factors associated with falls is impaired balance. Balance impairments and subsequent increased fall risk in older adults with type 2 diabetes are most commonly associated with diabetic peripheral neuropathy (DPN). Consequently, DPN has been the central focus of falls prevention research and interventions for older adults with type 2 diabetes. However, isolated studies have identified adults with type 2 diabetes without overt complications of DPN to also be at increased fall risk. It is known that the ability to maintain balance is a complex skill that requires the integration of multiple sensorimotor and cognitive processes. Emerging evidence suggests that diabetes-related subtle declines in sensory functions (somatosensory, visual and vestibular), metabolic muscle function and executive functions may also contribute to increased fall risk in older adults with type 2 diabetes. Knowledge of these type 2 diabetes-related sensorimotor and cognitive deficits may help to broaden approaches to falls prevention in older adults with type 2 diabetes. Therefore, the purpose of this mini review is to describe the impact of type 2 diabetes on sensorimotor and cognitive systems that may contribute to increased fall risk in older adults with type 2 diabetes. (C) 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.