TY - JOUR
T1 - Diabetic neuropathies influence recovery from hip-fracture surgery in older persons with diabetes
AU - Tseng, Ming Yueh
AU - Huang, Yueh Fang
AU - Liang, Jersey
AU - Wang, Jong Shyan
AU - Yang, Ching Tzu
AU - Wu, Chi Chuan
AU - Cheng, Huey Shinn
AU - Chen, Ching Yen
AU - Lin, Yueh E.
AU - Wang, Woan Shyuan
AU - Shyu, Yea Ing L.
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/5
Y1 - 2019/5
N2 - Background/objectives: To explore the impact of diabetic peripheral neuropathy (DPN) on the recovery of older persons with diabetes mellitus (DM) after hip-fracture surgery. Design, setting, participants: Secondary data for this study came from a clinical trial on the effectiveness of a DM-specific care model for 176 older persons (age ≥ 60) with DM over 2 years following hip-fracture surgery at a medical center in Taiwan. In the original trial, the experimental group (n = 88) received DM-specific care comprising diabetes care plus subacute care, and the control group (n = 88) received only usual care. Measurements: DPN was assessed using the Michigan Neuropathy Screening Instrument. Outcomes of self-care ability in activities of daily living (ADL), health-related quality of life (HRQoL), and depressive symptoms were assessed 1, 3, 6, 12, 18, 24 months following hospital discharge using the Chinese Barthel Index and Chinese-version instrumental ADL (IADL) scale; the SF-36 Taiwan version; and the Chinese-version Geriatric Depression Scale, short form, respectively. Results: After controlling for covariates, participants with DPN had 8.38 fewer points in ADL performance, 0.49 fewer points in IADL performance, and 2.33 fewer points in the physical component summary (PCS) of HRQoL than participants without DPN at 3 months following discharge. During the first year following discharge, the rate of improvement increased less for PCS (β = −0.45, p < 0.05), but more for the mental component summary (β = 0.49, p < 0.05) for those with DPN than for those without. During the second year, the rate of decline in physical function-related HRQoL increased slightly more for those with DPN than for those without (β = 0.03, p < 0.05). Conclusion: DPN adversely affected ADL performance, IADL performance, and physical function-related health outcomes for older persons recovering from hip-fracture surgery. These results suggest that older patients with DM recovering from hip-fracture surgery should be assessed and managed for DPN.
AB - Background/objectives: To explore the impact of diabetic peripheral neuropathy (DPN) on the recovery of older persons with diabetes mellitus (DM) after hip-fracture surgery. Design, setting, participants: Secondary data for this study came from a clinical trial on the effectiveness of a DM-specific care model for 176 older persons (age ≥ 60) with DM over 2 years following hip-fracture surgery at a medical center in Taiwan. In the original trial, the experimental group (n = 88) received DM-specific care comprising diabetes care plus subacute care, and the control group (n = 88) received only usual care. Measurements: DPN was assessed using the Michigan Neuropathy Screening Instrument. Outcomes of self-care ability in activities of daily living (ADL), health-related quality of life (HRQoL), and depressive symptoms were assessed 1, 3, 6, 12, 18, 24 months following hospital discharge using the Chinese Barthel Index and Chinese-version instrumental ADL (IADL) scale; the SF-36 Taiwan version; and the Chinese-version Geriatric Depression Scale, short form, respectively. Results: After controlling for covariates, participants with DPN had 8.38 fewer points in ADL performance, 0.49 fewer points in IADL performance, and 2.33 fewer points in the physical component summary (PCS) of HRQoL than participants without DPN at 3 months following discharge. During the first year following discharge, the rate of improvement increased less for PCS (β = −0.45, p < 0.05), but more for the mental component summary (β = 0.49, p < 0.05) for those with DPN than for those without. During the second year, the rate of decline in physical function-related HRQoL increased slightly more for those with DPN than for those without (β = 0.03, p < 0.05). Conclusion: DPN adversely affected ADL performance, IADL performance, and physical function-related health outcomes for older persons recovering from hip-fracture surgery. These results suggest that older patients with DM recovering from hip-fracture surgery should be assessed and managed for DPN.
KW - Diabetic peripheral neuropathy
KW - Health-related quality of life
KW - Hip fracture
KW - Older persons
KW - Self-care ability
UR - https://www.scopus.com/pages/publications/85061522469
U2 - 10.1016/j.exger.2019.02.004
DO - 10.1016/j.exger.2019.02.004
M3 - 文章
C2 - 30738920
AN - SCOPUS:85061522469
SN - 0531-5565
VL - 119
SP - 168
EP - 173
JO - Experimental Gerontology
JF - Experimental Gerontology
ER -
