110 Lower Hand Grip Strength Influences Falls Risk in Malaysians Aged 55 and above with Diabetes

Background Diabetes mellitus (DM) is a highly prevalent NCD affecting 20-30% of worldwide population with a rapidly rising prevalence in LMICs. It has been suggested that DM is one of the important risk factors for falls in older people attributed to complications. However, only a handful studies has evaluated the mechanisms of falls in diabetes. Aim To determine the potential mediating factors for falls individuals with diabetes mellitus Methods Cross-sectional analysis was conducted using the Malaysian Elders Longitudinal Study (MELoR) first wave data. The MELoR study recruited Klang Valley residents aged >55 years. DM was defined as fasting hyperglycaemia (serum fasting glucose > 6.66 mmol/l) or HbA1c > 42 mmol/mol (6.1%) or self-reported diabetes by participants or consumption of hypoglycaemic medications. Falls were identified by enquiring about the presence of fall in the past 12 months. Physical measurements obtained were hand grip strength (HGS), timed-up-and-go (TUG) and functional reach. Result Of 1579 participants, mean (SD) age 68.85 (7.48) years and 901 (57.1%) female, DM was present in 796 (50.4%) participants while 363 (22.9%) had falls in the past 12months. DM was associated with 35% of increased odds of falls compared to those without DM (odds ratio (95% CI)= 1.35 (1.07-1.71)). The association was remained significant after adjustment of demographic differences, body mass index and TUG. The associations were, however, attenuated after the inclusion of HGS in the model. Conclusion Weaker HGS appeared to account for the increased risk of falls in individuals aged 55 ears and above with DM. Reduced HGS is a marker including in the frailty phenotype. It is unclear why HGS rather than TUG, which is a composite measure of gait speed, lower limb girdle and dynamic balance mediated the relationship. A prospective study is required to determine the temporal relation between HGS and falls in diabetes.