Peripheral sensory nerve function, type 2 diabetes and frailty among men with cardiovascular disease

Objective: To investigated the cross-sectional association between peripheral sensory nerve function and frailty among community-dwelling men, and examine whether type 2 diabetes (T2D) modifies this association. Methods: A sample of 349 men [mean age = 77.1 ± 6.4 years; 37 % with T2D] who previously (1990–1998) participated in the Bezafibrate Infarction Prevention (BIP) trial, underwent assessment of frailty and legs vibratory thresholds (LVT), a measure of peripheral sensory nerve function, as part of the BIP Neurocognitive study during 2011–2013. LVT was assessed using a graduated tuning fork and frailty was assessed using the Fried criteria. An ordered logistic regression model was used to assess the link between LVT and degrees of frailty and to test for effect modification by T2D. Results: Overall, 117 (33.5 %) of patients were non-frail, 134 (38.4 %) pre-frail, and 98 (28.1 %) frail. A significant interaction between LVT and T2D with regard to frailty was found. Among men with T2D, estimated OR (95%CI) for increasing frailty at the 1st, 2nd, and 3rd as compared to the top LVT quartile were 13.5 (3.4–54.3), 5.9 (1.5–23.5), and 4.4 (1.20–16.0), respectively. Among men without T2D, the estimated ORs for increasing frailty in patients at the 1st, 2nd, and 3rd quartiles compared to the top LVT quartile were 2.8 (1.1–7.4), 1.6 (0.6–4.1), and 2.5 (1.0–6.5), respectively. Conclusion: Frailty is significantly associated with worsening peripheral sensory nerve function, particularly among men with T2D.