Frailty as a Predictor of Falls in Older Adults with Type 2 Diabetes

Background: Frailty and falls significantly impact the health and quality of life of older adults with type 2 diabetes (T2D), increasing morbidity and dependency. However, their association in Vietnamese populations remains understudied. This study aimed to examine the association between frailty and fall risk and identify additional fall-related factors among older Vietnamese outpatients with T2D.

Methods: A cross-sectional study was conducted among 740 outpatients with T2D aged ≥ 60 years at a geriatric hospital in Hanoi, Vietnam, from March 2024 to December 2024. Fall risk was assessed using the 21-item Fall Risk Index (21-FRI), and frailty was determined by the Clinical Frailty Scale (CFS). Four multivariable logistic regression models evaluated frailty’s association with falls, adjusting for demographics, diabetes-related factors, and geriatric syndromes.

Results: Among 740 older participants with T2D, 17.8% were frail, and 16.8% reported at least one fall in the past year. Frailty was strongly associated with a higher fall rate (p< 0.001). In the fully adjusted logistic regression model, frailty emerged as a powerful and independent predictor of falls, increasing the odds by over four-fold (AOR 4.47, 95% CI 2.00– 5.29). Other significant risk factors included advanced age, poor glycemic control, diabetic complications, and co-existing geriatric syndromes (depression, urinary incontinence, cognitive impairment, and sarcopenia).

Conclusion: Routine frailty screening should be integrated into T2D care to identify high-risk older adults and implement tailored fall prevention strategies.

Dinh, H. T., Ha, L. V. H., Luu, N. M., Do, T. T. T., Nguyen, T. T. H., Nguyen, T. X., Nguyen, A. T., Nguyen, A. L., Nguyen, H. T. T., Phan, H. H., Nguyen, T. N., & Vu, H. T. T. (2025). Frailty as a predictor of falls in older adults with type 2 diabetes: Evidence from Vietnam. Clinical Interventions in Aging, 20, 2641–2650. https://doi.org/10.2147/CIA.S560920