後期高齢者医療制度の視点からみた高齢糖尿病患者のロコモティブシンドロームの罹患率

抄録

【Purpose】Using classification of “the Medical Care System for Older Senior Citizens”, we clarified the incidence of locomotive syndrome (LS) in patients with diabetes by age group and examined the factors affecting the occurrence of complications of LS. 【Methods】We enrolled 80 older patients with type 2 diabetes and classified them by age into two groups: senior group, with age of 65–74 years (n = 53), and grand senior group, with age of 75 years and older (n = 27). The 25-question Geriatric Locomotive Function Scale (GLFS-25) was used to determine the presence/absence and stage of LS. General characteristics, diabetes control index, diabetic complications, knee extension force (KEF), and exercise habits were investigated and compared by the LS stage. In addition, a multivariate analysis was performed for factors affecting LS using the presence/absence of LS as the objective variable. 【Results】The incidence of LS was 52% in the senior group and 66% in the grand senior group, showing no significant difference by age group. In both senior and grand senior groups, KEF was significantly lower in those with LS than in those without LS, and the proportion of those with LS who had an exercise habit was lower. In the multivariate analysis, exercise habits were selected as a factor influencing LS in both the senior and grand senior groups. KEF was selected as a factor influencing LS in the grand senior groups. 【Discussion】The incidence of LS in the general Japanese population aged ≥60 years as assessed by GLFS-25 was approximately 30%. The prevalence rates of LS in both senior and grand senior groups were approximately twice those of the general population, and older patients with diabetes seemed to require more long-term care. The results of this study suggest that to prevent the onset of LS in older patients with diabetes, maintaining high muscle strength in the lower limbs and exercise habits are effective, and detection and management of the onset of LS should be timely.