DIABETES, PRE-DIABETES, AND FALLS IN OLDER ADULTS

描述（由申请人提供）：在老年人中，糖尿病可能会增加福尔斯跌倒和跌倒损伤的风险，特别是骨折。糖尿病还与下肢功能下降有关，这可能导致跌倒风险和独立生活困难。福尔斯和下肢功能不佳严重威胁着这一人群的健康和生活质量，但在老年糖尿病患者中对这些结局的危险因素研究甚少。最终，将需要进行审判，以确定如何防止或减轻这些后果。然而，关于糖尿病与福尔斯和下肢功能下降的危险因素之间的关系，还需要更完整和结论性的数据。在糖代谢受损（糖尿病前期）的老年人中采取措施预防这些结果也可能是谨慎的。需要进行研究以确定老年糖尿病前期成人是否有更高的福尔斯和下肢功能下降的风险，以及哪些风险因素可能导致任何风险增加。这一群体对于预防性干预措施的目标可能特别重要。健康、衰老和身体组成的动态（HABC）是一项在3，075名老年人（基线年龄为70-79岁）中进行的纵向研究，为评估糖尿病和糖尿病前期对福尔斯和下肢表现的影响提供了特殊的资源。HABC包括681名糖尿病患者和945名糖尿病前期患者，男性和女性人数大致相等，非洲裔美国人和白色参与者。在每年的诊所访视中收集了超过5年的福尔斯和下肢功能的测量结果。关于这些与糖尿病相关的结局的潜在预测因素，包括空腹血糖、HbA[lc]、体位性低血压、身体成分、周围神经病变、视力和药物治疗，有大量信息可用。此外，住院数据可用于调查与糖尿病相关的严重跌倒损伤。我们建议使用HABC数据进行二次分析，以调查糖尿病或糖尿病前期患者中福尔斯和下肢功能下降的风险因素，强调可能成为干预目标的风险因素。这些分析将为未来设计试验以预防糖尿病或糖尿病前期老年人的福尔斯并保持力量和平衡提供信息。

DESCRIPTION (provided by applicant): In older adults, diabetes may increase the risk of falls and fall injuries, particularly fractures. Diabetes is also associated with lower extremity performance decline, which may contribute to fall risk and difficulty with independent living. Falls and poor lower extremity performance represent serious threats to the health and quality of life for this population, yet there has been little study of the risk factors for these outcomes among older adults with diabetes. Ultimately, trials will be needed to ascertain how these consequences can be prevented or relieved. However, more complete and conclusive data about the relationship between diabetes and risk factors for falls and declining lower extremity performance are needed. Taking measures to prevent these outcomes among older adults with impaired glucose metabolism (pre-diabetes) may also prove prudent. Studies are needed to determine if older pre-diabetic adults have a higher risk of falls and decline in lower extremity performance and what risk factors might account for any increased risk. This group might be especially important to target for preventive interventions. The Dynamics of Health, Aging and Body Composition (HABC), a longitudinal study among 3,075 older adults (70-79 years old at baseline), provides an exceptional resource to assess the influence of diabetes and pre-diabetes on falls and lower extremity performance. HABC includes 681 participants with diabetes and 945 participants with pre-diabetes, approximately equal numbers of men and women, and African-American and white participants. Measurements of falls and lower extremity performance are being collected over five years at annual clinic visits. A wealth of information is available on potential predictors of these outcomes that are related to diabetes, including fasting glucose, HbA[lc], postural hypotension, body composition, peripheral neuropathy, vision, and medications. In addition, data from hospital admissions are available to investigate serious fall injuries associated with diabetes. We propose performing secondary analyses using HABC data to investigate the risk factors for falls and lower extremity performance decline among those with diabetes or pre-diabetes, emphasizing risk factors that might be a target of intervention. These analyses will inform future efforts to design trials to prevent falls and maintain strength and balance in older adults with diabetes or pre-diabetes.