Prospective association among diabetes diagnosis, HbA1c, glycemia, and frailty trajectories in an elderly population

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  • Gloria A. Aguayo, Luxembourg Institute of Health
  • ,
  • Adam Hulman
  • Michel T. Vaillant, Luxembourg Institute of Health
  • ,
  • Anne Françoise Donneau, University of Liege
  • ,
  • Anna Schritz, Luxembourg Institute of Health
  • ,
  • Saverio Stranges, Luxembourg Institute of Health, Western University
  • ,
  • Laurent Malisoux, Luxembourg Institute of Health
  • ,
  • Laetitia Huiart, Luxembourg Institute of Health
  • ,
  • Michèle Guillaume, University of Liege
  • ,
  • Séverine Sabia, Institut National de la Recherche Agronomique, UCL
  • ,
  • Daniel R. Witte

Objective: Frailty is a dynamic state of vulnerability in the elderly. We examined whether individuals with overt diabetes or higher levels of HbA1c or fasting plasma glucose (FG) experience different frailty trajectories with aging. Research Design and Methods: Diabetes, HbA1c, and FG were assessed at baseline, and frailty status was evaluated with a 36-item frailty index every 2 years during a 10-year follow-up among participants from the English Longitudinal Study of Ageing (ELSA). Mixed-effects models with age as time scale were used to assess whether age trajectories of frailty differed as a function of diabetes, HbA1c, and FG. Results: Among 5,377 participants (median age [interquartile range] 70 [65, 77] years, 45% men), 35% were frail at baseline. In a model adjusted for sex, participants with baseline diabetes had an increased frailty index over aging compared with those without diabetes. Similar findings were observed with higher levels of HbA1c, while FG was not associated with frailty. In a model additionally adjusted for income, social class, smoking, alcohol, and hemoglobin, only diabetes was associated with an increased frailty index. Among nonfrail participants at baseline, both diabetes and HbA1c level were associated with a higher increased frailty index over time. Conclusions: People with diabetes or higher HbA1c levels at baseline had a higher frailty level throughout later life. Nonfrail participants with diabetes or higher HbA1c also experienced more rapid deterioration of frailty level with aging. This observation could reflect a role of diabetes complications in frailty trajectories or earlier shared determinants that contribute to diabetes and frailty risk in later life.

OriginalsprogEngelsk
TidsskriftDiabetes Care
Vol/bind42
Nummer10
Sider (fra-til)1903-1911
Antal sider9
ISSN0149-5992
DOI
StatusUdgivet - 2019

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