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.

BACKGROUND: Fear of falling is a common and potentially disabling problem among older adults. However, little is known about this condition in older adults with diabetes mellitus. The aims of this study were to investigate the impact of the fear of falling on clinical, functional and gait variables in older women with type 2 diabetes and to identify which variables could predict the fear of falling in this population. METHODS: Ninety-nine community-dwelling older women with type 2 diabetes (aged 65 to 89 years) were stratified in two groups based on their Falls Efficacy Scale-International score. Participants with a score < 23 were assigned to the group without the fear of falling (n = 50) and those with a score ≥ 23 were assigned to the group with the fear of falling (n = 49). Clinical data included demographics, anthropometrics, number of diseases and medications, physical activity level, fall history, frailty level, cognition, depressive symptoms, fasting glucose level and disease duration. Functional measures included the Timed Up and Go test (TUG), the five times sit-to-stand test (5-STS) and handgrip strength. Gait parameters were obtained using the GAITRite® system. RESULTS: Participants with a fear of falling were frailer and presented more depressive symptoms and worse performance on the TUG and 5-STS tests compared with those without a fear of falling. The group with the fear of falling also walked with a lower velocity, cadence and step length and increased step time and swing time variability. The multivariate regression analysis showed that the likelihood of having a fear of falling increased 1.34 times (OR 1.34, 95 % CI 1.11-1.61) for a one-point increase in the Geriatric Depression Scale (GDS-15) score and 1.36 times (OR 1.36, 95 % CI 1.07-1.73) for each second of increase in the TUG performance. CONCLUSIONS: The fear of falling in community-dwelling older women with type 2 diabetes mellitus is associated with frailty, depressive symptoms and dynamic balance, functional mobility and gait deficits. Furthermore, both the GDS-15 and the TUG test predict a fear of falling in this population. Therefore, these instruments should be considered during the assessment of diabetic older women with fear of falling.

Effects of aerobic exercise on functional capacity, anthropometric measurements and inflammatory markers in diabetic elderly women.

This study investigated the effects of an aerobic training program on functional capacity [Timed Up and Go test (TUG), timed 10-m walk test (10MWT), five-repetition sit-to-stand test (5-STS), handgrip strength test (HGS) and one-legged stance test (OLS)], anthropometric measurements [body mass, body mass index (BMI), waist and hip circumferences and waist-to-hip ratio] and plasma levels of inflammatory markers [soluble tumor necrosis factor receptors 1 and 2, and interleukins 6 and 10] in 43 elderly women with type 2 diabetes mellitus. After the training, a significant improvement was observed in the performance of the participants on the TUG, 10MWT, 5-STS and HGS and in the anthropometric measures of body mass, BMI and hip circumference. None of the inflammatory markers showed a significant difference between pre- and post-training. The aerobic exercise program improved the functional capacity of diabetic elderly women, but was ineffective to change the levels of the inflammatory markers evaluated.