TY - JOUR
T1 - Prospective association among diabetes diagnosis, HbA1c, glycemia, and frailty trajectories in an elderly population
AU - Aguayo, Gloria A.
AU - Hulman, Adam
AU - Vaillant, Michel T.
AU - Donneau, Anne Françoise
AU - Schritz, Anna
AU - Stranges, Saverio
AU - Malisoux, Laurent
AU - Huiart, Laetitia
AU - Guillaume, Michèle
AU - Sabia, Séverine
AU - Witte, Daniel R.
N1 - Funding Information:
Acknowledgments. The authors thank Stephen Senn (Competence Center for Methodology and Statistics, Luxembourg Institute of Health, Stras-sen, Luxembourg) for his contribution to this study. The authors thank the UK Data Archive for supplying the ELSA data. ELSA was developed by a team of researchers based at University College London, the Institute of Fiscal Studies, and the National Centre for Social Research (data sharing project number 82538). Funding. This work was supported by the Ministry of Higher Education and Research of Luxembourg through an internal project (number 20140511) from the Luxembourg Institute of Health (funding G.A.A.). A.H. and D.R.W. are supported by the Danish Diabetes Academy, which is funded by the Novo Nordisk Foundation.
Publisher Copyright:
© 2019 by the American Diabetes Association.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85072525893&partnerID=8YFLogxK
U2 - 10.2337/dc19-0497
DO - 10.2337/dc19-0497
M3 - Article
C2 - 31451533
AN - SCOPUS:85072525893
SN - 0149-5992
VL - 42
SP - 1903
EP - 1911
JO - Diabetes Care
JF - Diabetes Care
IS - 10
ER -