Background Polypharmacy and its adverse health effects is an emerging public health issue, with increasing prevalence among patients with multiple chronic conditions, such as older adults with diabetes. A healthy lifestyle has been shown to improve both diabetes and polypharmacy incidence. We conducted a cross-sectional study to investigate the association of a healthy lifestyle with polypharmacy and comorbidities in older people with diabetes. Methods All out-patients from January 2013 to June 2015 with type II diabetes aged 65 years or more from a Lazio Region reference centre for diabetes were included in the study. Socio-demographic, clinical and lifestyle data were collected from medical records and through face-to-face standardized questionnaires. The comorbidity-polypharmacy score (CPS) was used to characterize the overall patients’ frailty, by assessing concurrently the presence of comorbidities and polypharmacy. The cumulative logit model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results Adjusted ORs for age, sex, body mass index, physical activity and cognitive status, showed that CPS score was inversely related to weekly consumption of cruciferous vegetables (OR: 0.56, 95% CI: 0.35–0.90; P-trend = 0.015), leafy green vegetables (OR: 0.54, 95% CI: 0.33–0.87; P-trend = 0.013) and daily intake of fruits (OR: 0.63, 95% CI: 0.41–0.97; P-trend = 0.036). Walking outdoors was found inversely related to CPS score (age- and sex-adjusted OR: 0.60, 95% CI: 0.42–0.86). Conclusion Our findings suggest that eating some dietary factors present in the Mediterranean diet and walking outdoors regularly is associated with a lower intensity of medicines need to treat comorbidities among older people with diabetes.

中文翻译：

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老年 II 型糖尿病患者的地中海饮食、户外步行和多种药物治疗

背景 多重用药及其对健康的不利影响是一个新兴的公共卫生问题，在患有多种慢性病的患者中越来越流行，例如患有糖尿病的老年人。健康的生活方式已被证明可以改善糖尿病和多种药物的发病率。我们进行了一项横断面研究，以调查健康生活方式与老年糖尿病患者的多种药物治疗和合并症之间的关系。方法 将 2013 年 1 月至 2015 年 6 月拉齐奥地区糖尿病参考中心所有年龄在 65 岁及以上的 II 型糖尿病门诊患者纳入研究。从医疗记录和面对面的标准化问卷中收集社会人口学、临床和生活方式数据。合并症-多种药物评分（CPS）用于表征整体患者的虚弱程度，通过同时评估合并症和多种药物的存在。累积 logit 模型用于估计优势比 (OR) 和 95% 置信区间 (CI)。结果 调整年龄、性别、体重指数、体力活动和认知状态的 OR，显示 CPS 评分与每周食用十字花科蔬菜呈负相关（OR：0.56，95% CI：0.35-0.90；P 趋势 = 0.015） , 绿叶蔬菜 (OR: 0.54, 95% CI: 0.33–0.87; P-trend = 0.013) 和每日水果摄入量 (OR: 0.63, 95% CI: 0.41–0.97; P-trend = 0.036)。发现户外步行与 CPS 评分呈负相关（年龄和性别调整的 OR：0.60，95% CI：0.42-0.86）。