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Review of motivational strategies to prevent frailty in older adults with diabetes

An estimated 1.5 million Americans are diagnosed with diabetes each year with more than 25 percent of seniors (65+) currently living with the disease. Medical expenditures for persons with diabetes are more than twice as high as those for patients without diabetes. 

“Diabetes in older adults often times coexists with frailty, resulting in reduced quality of life and increased health-care use,” said Joan A. Vaccaro, adjunct professor and research scientist in the Department of Dietetics and Nutrition at the Robert Stempel College of Public Health & Social Work. “There is a need to motivate and empower older adults with type 2 diabetes to make lifestyle changes to prevent frailty.”

Many older adults with type 2 diabetes have mobility impairments and experience falls, contributing to increased frailty. Exercise has a protective effect for frailty and falls, yet less than half of those with diabetes exercise. In addition to exercise, nutrition may help reduce the risk for falls. 

Dr. Vaccaro, along with other FIU researchers, found that there is insufficient evidence to create nutritional guidelines specific for frail older adults with type 2 diabetes. 

“The purpose of this review was to identify and integrate what is known and what still needs to be done for this population to be successful in making health behavior changes to reduce frailty,” Dr. Vaccaro continued. 

There is some evidence that motivational approaches have worked for older adults with various chronic disease conditions. However, studies applying motivational strategies are lacking for frail older adults with type 2 diabetes. 

In a new paper published in the Journal of Aging Research, the team of researchers describe a novel motivational approach that combines aspects of the Health Belief Model and Motivational Interviewing. Intervention studies incorporating these models are needed to determine whether this client-driven strategy can help various racial/ethnic populations make the sustainable health behavior changes of increasing exercise and healthy eating while taking into consideration physiological, psychological, and economic barriers.

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