2172-P: Prediabetes Is Associated with Incident Frailty in Community-Dwelling Older Adults: A Five-Year Time-to-Event Analysis from the Bunkyo Health Study

Introduction and Objective: Preventing frailty in an aging society is a critical challenge. Diabetes mellitus (DM) is an established risk factor for frailty, but prospective studies on whether prediabetes (PreDM) is a risk factor have been limited and inconclusive. Furthermore, most studies define PreDM using fasting glucose or HbA1c rather than OGTT. We examined whether PreDM, as defined by OGTT, is associated with frailty onset in community-dwelling older adults. Methods: Among 1,629 participants in the Bunkyo Health Study, 1,397 who were not frail at 1-year follow-up were included (baseline for incident frailty surveillance). Frailty was assessed annually from year 1 to year 5 using the Kihon Checklist (KCL; frailty defined as a score ≥8). Baseline glucose tolerance status was classified as normal glucose tolerance (NGT), PreDM, or DM based on the 75g OGTT, HbA1c, and use of glucose-lowering medication. Cumulative frailty incidence was compared using Kaplan-Meier curves and log-rank tests, and Cox proportional hazards models adjusted for age and sex were used to estimate hazard ratios (HRs). Results: The 5-year cumulative incidence of frailty was 18.3% (NGT), 24.9% (PreDM), and 25.8% (DM). Kaplan-Meier analysis showed a stepwise increase in cumulative frailty incidence across the NGT, PreDM, and DM groups (log-rank test p=0.007). In the Cox proportional hazards model, PreDM was independently associated with an increased risk of frailty onset compared to NGT (HR 1.33, 95% CI 1.02-1.72), and the risk further increased in DM (HR 1.44, 95% CI 1.07-1.94). Conclusion: In community-dwelling older adults, PreDM and DM are associated with an increased risk of new frailty onset. Annual surveillance based on KCL enables time-series analysis demonstrating a progressive increase in frailty risk associated with deteriorating glucose tolerance, supporting the initiation of early detection and prevention strategies from the PreDM stage onward. Disclosure T. Kogai: None. H. Kaga: None. H. Naito: None. H. Tabata: None. R. Mori: None. E. Takagi: None. S. Sakamoto: None. S. Kakehi: None. H. Watada: Research Support; Current; Sumitomo Pharma Co. Ltd., Sanwa Kagaku Kenkyusho, Kowa Company, Ltd., Taiho Pharmaceutical Co. Ltd., SBI pharma, Boehringer Ingelheim International GmbH. Speaker's Bureau; Current; Novo Nordisk, Boehringer Ingelheim International GmbH, Sumitomo Pharma Co. Ltd., Lilly, Roche Diagnostics, Merck Sharp Current; Ono Pharmaceutical Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Kowa Research Institute, Inc. Research Support; Ended; Kowa Research Institute, Inc.