Geriatric rehabilitation with diabetes mellitus and frailty: a subanalysis of POSTSCRIPTUM study
Bibliographic record
Abstract
Introduction. Functional activity and independence of elderly people with type 2 diabetes mellitus (DM2) depend not only on the glycaemic control, but also on the severity of geriatric syndromes. This subanalysis was conducted to study the peculiarities of the effect of individual geriatric rehabilitation (GR) programs on functional status in patients with type 2 DM2 and frailty. Aim. Evaluation of the effect of geriatric rehabilitation on the level of functional activity in patients with DM2 and frailty. Materials and methods. A subanalysis of data from POSTSCRIPTUM, a multicentre, prospective study, was conducted to evaluate the effectiveness of 21-day geriatric rehabilitation programmes for patients aged 60 years and over with senile asthenia syndrome. The subanalysis included 475 patients, who were divided into two groups: 91 patients with type 2 diabetes mellitus (DM2+ group) and 384 patients without DM (DM2– group). On visit 1, a comprehensive geriatric assessment (CGA) was performed, and a personalized 21-day GR program was developed. Visit 2 took place after the completion of GR to evaluate the effectiveness of the course. Results and discussion. The frequency of diagnosing geriatric syndromes (GS) and the distribution of frailty severity were comparable in the DM2+ and DM2– groups. Frailty was found in 38 % in the DM2+ group and 34 % in the DM2– group. Median age in the DM2+ and DM2– groups was 76 [71; 81.5] vs 80 [73; 84] years, p = 0.001. After the 3-week GR program, the DM2+ group showed an improvement in a brief battery of physical functioning tests (p 0.001), an increase in the mean MoCA (Montreal Cognitive Assessment) score of 2.06 ± 0.38 (p 0.001), a decrease in pain intensity in self-assessments according to the visual analog scale in the last week (p 0.001), decreased insomnia severity index p = 0.03), and improved MNA (Mini Nutritional Assessment) score (p = 0.006). The subgroup of patients with preasthenia gravis additionally demonstrated improvements in baseline activities of daily living, nutritional status, and a decrease in the insomnia severity index. Conclusion. The POSTSCRIPTUM study demonstrated the effectiveness of short-term individualized GR programs based on CGA results in patients with DM2 and frailty in improving physical and cognitive status; pain severity; while the subgroup of patients with preasthenia gravis showed improvement in baseline activities of daily living, nutritional status, and a decrease in the insomnia severity index.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".