Frailty incidence by diabetes treatment regimens in older adults with diabetes mellitus in the ASPirin in Reducing Events in the Elderly Study

Sara E Espinoza; Jonathan C Broder; Rory Wolfe; Michael E Ernst; Raj C Shah; Suzanne G Orchard; Robyn L Woods; Joanne Ryan; Anne Murray

doi:10.1007/s11357-025-01598-6

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Frailty incidence by diabetes treatment regimens in older adults with diabetes mellitus in the ASPirin in Reducing Events in the Elderly Study

Journal article

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Frailty incidence by diabetes treatment regimens in older adults with diabetes mellitus in the ASPirin in Reducing Events in the Elderly Study

Sara E Espinoza, Jonathan C Broder, Rory Wolfe, Michael E Ernst, Raj C Shah, Suzanne G Orchard, Robyn L Woods, Joanne Ryan and Anne Murray

GeroScience, Vol.47(3), pp.5169-5183

06/2025

DOI: 10.1007/s11357-025-01598-6

PMCID: PMC12181461

PMID: 40097879

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Abstract

Diabetes mellitus is a major risk factor for frailty in older adults, and studies suggest that frailty risk may differ by diabetes treatment regimen. To investigate the association between diabetes medication use and frailty, we conducted an observational cohort analysis of older adults with diabetes enrolled in the ASPirin in Reducing Events in the Elderly (ASPREE) study. Diabetes at baseline (N = 2045) was defined as self-reported diabetes, fasting blood glucose levels > 125 mg/dL, or use of diabetes medication. Diabetes medication exposure at baseline was categorized as use of metformin only (monotherapy) (N = 545), metformin combined with other diabetes medications (N = 420), other diabetes medications only (N = 200), or no diabetes medications (N = 880). Frailty was defined using a modified Fried frailty phenotype (presence of ≥ 3 of 5 criteria) and a deficit accumulation frailty index (FI, score > 0.21/1.00). Mixed effects ordinal logistic regression models revealed the odds of frailty at baseline were highest for the other diabetes medications only group, but this difference remained consistent over follow-up. After adjustment for covariates, including baseline pre-frailty, no differences in the rates of Fried or FI frailty were observed among the diabetes medication exposure groups. These findings suggest that diabetes medication exposure in older adults with diabetes does not directly impact frailty risk.

Diabetes

Frailty

Metformin

Older adults

Details

Title: Subtitle: Frailty incidence by diabetes treatment regimens in older adults with diabetes mellitus in the ASPirin in Reducing Events in the Elderly Study
Creators: Sara E Espinoza - Cedars-Sinai Medical Center
Jonathan C Broder - Monash University
Rory Wolfe - Monash University
Michael E Ernst - University of Iowa
Raj C Shah - Rush University
Suzanne G Orchard - Monash University
Robyn L Woods - Monash University
Joanne Ryan - Monash University
Anne Murray - Hennepin Healthcare Research Institute
Resource Type: Journal article
Publication Details: GeroScience, Vol.47(3), pp.5169-5183
DOI: 10.1007/s11357-025-01598-6
PMID: 40097879
PMCID: PMC12181461
NLM abbreviation: Geroscience
ISSN: 2509-2723
eISSN: 2509-2723
Publisher: Springer Nature; DORDRECHT
Grant note: U01AG029824 / NIA NIH HHS R01AG069690 / NIA NIH HHS 334047 / National Health and Medical Research Council of Australia 1135727 / National Health and Medical Research Council of Australia R01AG052697 / NIA NIH HHS R01AG089711 / NIA NIH HHS 1127060 / National Health and Medical Research Council of Australia
Language: English
Electronic publication date: 03/17/2025
Date published: 06/2025
Academic Unit: Family and Community Medicine; Pharmacy Practice and Science
Record Identifier: 9984801837002771

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