Study Links Diabetes Drugs to Slower Frailty Progression in Older Adults

A new study shows that older adults with type 2 diabetes experience slower frailty progression over one year when they start treatment with SGLT-2 inhibitors, such as Jardiance or Farxiga, or GLP-1 receptor agonists, such as Ozempic or Victoza, compared with those who begin other diabetes medications. The findings suggest these medications could help older adults maintain strength, mobility, and independence beyond their well-known effects on blood sugar and heart health.

The study, entitled “Sodium-Glucose Cotransporter-2 Inhibitors, Glucagon-Like Peptide-1 Receptor Agonists, and Frailty Progression in Older Adults With Type 2 Diabetes,” and published in Diabetes Care, examined older adults who had recently begun taking different diabetes medications and followed them over the course of one year. It found that people taking SGLT-2 inhibitors or GLP-1 receptor agonists were less likely to show signs of frailty, such as weakness, slowed movement, or fatigue, compared with those starting other diabetes medications. In other words, these treatments appeared to help patients with diabetes maintain strength and function as they aged. The benefit could not be fully explained by heart benefits, suggesting the medications may directly help protect against frailty.

Analyzing a national 7% sample of U.S. Medicare claims, researchers tracked one-year changes in a validated claims-based frailty index (CFI; range 0–1, with higher scores indicating greater frailty). Compared with new users of DPP-4 inhibitors, those starting GLP-1 receptor agonists saw a mean CFI change of –0.007 (95% CI: –0.011 to –0.004) and those starting SGLT-2 inhibitors saw a mean change of –0.005 (95% CI: –0.008 to –0.002), indicating slower frailty progression. Users of sulfonylureas showed no significant difference. Additional analyses found that cardiovascular or other safety events accounted for only a small portion of the effect, suggesting a potential direct benefit of these medications on frailty.

According to prior research, roughly 10-15% of adults over age 65 experience frailty, with higher rates in those with type 2 diabetes. People with diabetes are particularly at risk due to chronic inflammation, muscle loss, cardiovascular disease, and the cumulative burden of managing a complex condition. Frailty is associated with falls, disability, hospitalization, and reduced lifespan. Because it is difficult to reverse, slowing frailty progression has emerged as an important goal in geriatric care, making the findings of this study especially significant for older adults with diabetes.

“While SGLT-2 inhibitors and GLP-1 receptor agonists are primarily prescribed for blood sugar control and heart protection, our findings show they may also help older adults with diabetes stay stronger and be less vulnerable to health setbacks,” said lead author of the study, Chanmi Park, MD, MPH, assistant scientist I at Hebrew SeniorLife’s Hinda and Arthur Marcus Institute for Aging Research. “Because frailty is common, serious, and hard to reverse, this could meaningfully change how clinicians think about medication choices for aging patients.”

In addition to Dr. Park, the other researchers were Saran Thanapluetiwong, MD, visiting research fellow, Marcus Institute, Hebrew SeniorLife; Xiecheng Chen, PhD, data scientist I, Marcus Institute, Hebrew SeniorLife; Gahee Oh, MD, MPH, data scientist II, Marcus Institute, Hebrew SeniorLife; Darae Ko, MD, MSc, associate scientist, Marcus Institute, Hebrew SeniorLife; and Dae Hyun Kim, MD, MPH, ScD, associate director and senior scientist, Marcus Institute, Hebrew SeniorLife.

About Hebrew SeniorLife
Hebrew SeniorLife, an affiliate of Harvard Medical School, is a national senior services leader uniquely dedicated to rethinking, researching, and redefining the possibilities of aging. Hebrew SeniorLife cares for more than 4,500 seniors a day across seven campuses throughout Greater Boston. Locations include: Hebrew Rehabilitation Center-Boston and Hebrew Rehabilitation Center-NewBridge in Dedham; NewBridge on the Charles, Dedham; Orchard Cove, Canton; Simon C. Fireman Community, Randolph; Center Communities of Brookline, Brookline; Jack Satter House, Revere; and Leyland Community, Dorchester. Founded in 1903, Hebrew SeniorLife also conducts influential research into aging at the Hinda and Arthur Marcus Institute for Aging Research, which has a portfolio of more than $87 million, making it one of the largest gerontological research facilities in the U.S. in a clinical setting. It also trains more than 500 geriatric care providers each year. For more information about Hebrew SeniorLife, follow us on our blog, Facebook, Instagram, and LinkedIn.