HbA1c and physical performance in older adults from different aging epidemiological contexts: Longitudinal findings of the International Mobility in Aging Study (IMIAS)
HbA1c; physical performance; older people
Background and objective: Glycated hemoglobin A1c or HbA1c refers to a blood marker that reflects the level of glucose in the body for up to 3 months. Understanding the relationship between HbA1c and functionality in the elderly can contribute to promoting effective and well-targeted health care strategies to prevent disabilities and injuries. This study aims to evaluate the longitudinal association between glycated hemoglobin A1c (HbA1c) and physical performance scores in different epidemiological contexts of aging. Material and Methods: Longitudinal data were used from 1,337 people from the International Mobility in Aging Study (IMIAS) from three countries (Canada, Brazil and Colombia) to evaluate associations between HbA1c and Short Physical Performance Battery (SPPB) scores between 2012 and 2016. Multiple linear regression models adjusted for gender, age, study site, chronic conditions, anthropometric measurements and inflammatory level were used. Mixed linear models were used to estimate the influence of covariates on SPPB scores. Results: In preliminary analyses, cities in Latin America had higher averagehba1c compared to Canadian cities, with Natal (Brazil) being the city with the highest HbA1c averages in men and women (6.32 ±; 6.56 ± respectively). In the multivariate mixed linear models of longitudinal analyses, HbA1c was significantly associated with lower SPPB scores in men (β = -0.25, 95% CI: -0.39 to -0.12, p value = 0.02), but not in women. Conclusion: Sex differences were identified in the relationship between high HbA1c levels with lower physical performance scores when adjusted by social, anthropometric, and clinical variables