Fear of Falling in Type 2 Diabetic Older Patients with and without Peripheral Neuropathy
Keywords:
Type 2 Diabetic Mellitus; Peripheral; neuropathy; Fear of falling; Older adultAbstract
Background and Objective: Older adults with type 2 diabetic mellitus have long-term hyperglycemia that leads to peripheral neuropathy. Diabetic peripheral neuropathy (DPN) leads to loss of protective sensitivity of foot, resulting to falling in diabetic patients. In addition, DPN may be increase fear of falling (FOF) and lead to a limitation of the performance of daily activity. However, the associations between the FOF and type 2 diabetic older patients with and without peripheral neuropathy in Thailand have not been study yet. Thus, the propose of this study was to compare the fear of falling in older adults with and without type 2 diabetic peripheral neuropathy and healthy older adults.
Methods: One hundred fourteen participants were divided into three groups; i) type 2 diabetic older patients with peripheral neuropathy group (n = 38), ii) type 2 diabetic older patients without peripheral neuropathy group (n= 38) and, iii) normal elderly group (n = 38). All subjects were evaluated FOF by the Falls Efficacy Scale-International (FES-I).
Results: Type 2 diabetic older patients with peripheral neuropathy group showed significantly higher scores of FOF test (33.36±6.98) as compared to those of the type 2 diabetic older patients without peripheral neuropathy group (24.34±6.76) and the healthy older adult group (16.39±0.50) (p < 0.05). Moreover, FOF score in the type 2 diabetic older patients without peripheral neuropathy group was significant higher than healthy older adult group (p < 0.05).
Conclusion: The FOF in type 2 diabetic older patients with peripheral neuropathy was higher than type 2 diabetic older patients without peripheral neuropathy and healthy older adult, which was a main contributory factor of falling among elderly.
References
2. สุพัตรา ศรีวณิชชากร. สถานการณ์การป่วยและการตายด้วยโรคไม่ติดต่อเรื้อรัง (โรคเบาหวานชนิดที่ 2 และโรคหัวใจและหลอดเลือด) ในประเทศไทยในระยะ 5 ปี (2553-2557). 2560; 43: 379-90.
3. Oguejiofor OC, Odenigbo CU, Oguejiofor CB. Evaluation of the effect of duration of diabetes mellitus on peripheral neuropathy using the United Kingdom screening test scoring system, bio-thesiometry and aesthesiometry. Niger J Clin Pract 2010;13: 240-7.
4. Kelly C, Fleischer A, Yalla S, Grewal GS, Albright R, Berns D, et al. Fear of falling is prevalent in older adults with diabetes mellitus but is unrelated to level of neuropathy. J Am Podiatr Med Assoc 2013; 103: 480-8.
5. Pinheiro HA, Vilaça KHC, Carvalho GdA. Assessment of muscle mass, risk of falls and fear of falling in elderly people with diabetic neuropathy. Fisioter Mov 2015; 28: 677-83.
6. Timar B, Timar R, Gaiță L, Oancea C, Levai C, Lungeanu D. The impact of diabetic neuropathy on balance and on the risk of falls in patients with type 2 diabetes mellitus: a cross-sectional study. PLos One 2016; 11: 1-11.
7. Bokan-Mirković V, Škarić-Karanikić Ž, Nejkov S, Vuković M, Ćirović D. Diabetic polyneuropathy and risk of falls: fear of falling and other factors. Acta Clin Croat 2017; 56: 721-7.
8. Legters K. Fear of falling. Phys Ther 2002; 82: 264-72.
9. de Souza Moreira B, Dos Anjos DMdC, Pereira DS, Sampaio RF, Pereira LSM, Dias RC, et al. The geriatric depression scale and the timed up and go test predict fear of falling in community-dwelling elderly women with type 2 diabetes mellitus: a cross-sectional study. BMC Geriatrics 2016;16: 1-10.
10. Sankhe P, Ganvir S. Association between Physical Functioning and Fear of Falling with Balance in Elderly Diabetic Individuals.Physiother Rehabil 2017; 02: 1-5.
11. Tander B, Atmaca A, Ulus Y, Tura Ç, Akyol Y, Kuru Ö, et al. Balance performance and fear of falling in older patients with diabetics: a comparative study with non-diabetic elderly. Turk J Phys Med Rehab 2016; 62: 314-22.
12. Bruce D, Hunter M, Peters K, Davis T, Davis W. Fear of falling is common in patients with type 2 diabetes and is associated with increased risk of falls. Age Ageing 2015; 44: 687-90.
13. Meijer J, Smit A, Sonderen E, Groothoff J, Eisma W, Links T. Symptom scoring systems to diagnose distal polyneuropathy in diabetes: the Diabetic Neuropathy Symptom score. Diabet Med 2002; 19: 962-5.
14. สถาบันวิจัยและประเมินเทคโนโลยีทางการแพทย์ กรมการแพทย์. แนวทางเวชปฏิบัติการป้องกันและดูแลรักษาผู้ป่วยเบาหวานที่มีภาวะแทรกซ้อนที่เท้า. นนทบุรี: ชุมนุมสหกรณ์การเกษตรแห่งประเทศไทย จำกัด, 2556.
15. สมาคมโรคเบาหวานแห่งประเทศไทย. แนวเวชปฏิบัติสำหรับโรคเบาหวาน 2554. กรุงเทพมหานคร: ศรีเมืองการพิมพ์, 2554.
16. ลัดดา เถียมวงศ์. การทดสอบคุณสมบัติของเครื่องมือประเมินอาการกลัวการหกล้มในผู้สูงอายุไทย. สงขลานครินทร์เวชสาร 2554; 29: 277-87.
17. Delbaere K, Close JC, Mikolaizak AS, Sachdev PS, Brodaty H, Lord SR. The falls efficacy scale international (FES-I). A comprehensive longitudinal validation study. Age Ageing 2010; 39: 210-6.
18. de Souza Moreira B, Ferreira Sampaio R, Rossana Cavalcanti Furtado S, Correa Dias R, Noce Kirkwood R. The relationship between diabetes mellitus, geriatric syndromes, physical function, and gait: a review of the literature. Curr Diabetes Rev 2016; 12: 240-51.
19. Munshi M, Grande L, Hayes M, Ayres D, Suhl E, Capelson R, et al. Cognitive dysfunction is associated with poor diabetes control in older adults. Diabetes Care 2006; 29: 1794-9.
20. de Souza Moreira B, Sampaio RF, Diz JBM, de Carvalho Bastone A, Ferriolli E, Neri AL, et al. Factors associated with fear of falling in community-dwelling older adults with and without diabetes mellitus: findings from the Frailty in Brazilian Older People Study (FIBRA-BR). Exp Gerontol 2017; 89: 103-11.
21. Doi T, Ono R, Ono K, Yamaguchi R, Makiura D, Hirata S. The association between fear of falling and physical activity in older women. J Phys Ther Sci 2012; 24: 859-62.
22. Alam U, Asghar O, Azmi S, Malik RA. General aspects of diabetes mellitus. Handb Clin Neurol 2014; 126: 211-22.
23. Hewston P, Deshpande N. Falls and balance impairments in older adults with type 2 diabetes: thinking beyond diabetic peripheral neuropathy. Can J Diabetes 2016; 40: 6-9.
24. Kang GE, Najafi B. Sensor-Based Daily Physical Activity: Towards Prediction of the Level of Concern about Falling in Peripheral Neuropathy. Sensors 2020; 20: 1-11.
25. Litwin H, Erlich B, Dunsky A. The complex association between fear of falling and mobility limitation in relation to late-life falls: a SHARE-based analysis. J Aging Health 2018; 30: 987-1008.
