Diabetes, inflammation, and functional decline in older adults

Findings from the health, aging and body composition (ABC) study

M. Kathleen Figaro, Stephen B. Kritchevsky, Helaine E. Resnick, Ronald I. Shorr, Javed Butler, Ayumi Shintani, Brenda W. Penninx, Eleanor Marie Simonsick, Bret H. Goodpaster, Anne B. Newman, Ann V. Schwartz, Tamara B. Harris

Research output: Contribution to journalArticle

Abstract

OBJECTIVE - Age, diabetes, and elevated inflammatory markers independently increase the risk of functional decline. We examined the effect of C-reactive protein (CRP) and interleukin-6 (IL-6) on the incident mobility limitation in older adults with and without diabetes. RESEARCH DESIGN AND METHODS - We analyzed data from a cohort of 2,895 well-functioning adults aged 70-79 years, followed for development of persistent functional limitation over 3.5 years. Participants were assessed for the presence of diabetes according to fasting glucose and/or hypoglycemic medication use and were divided into three equal groups (tertiles) according to level of CRP or IL-6. Persistent functional limitation was defined as difficulty climbing 10 steps or walking one-quarter mile on two consecutive semiannual assessments. RESULTS - At baseline, 702 participants (24%) had diabetes. CRP values were (median ± SD) 2.8 ± 4.4 versus 3.7 ± 5.4 for those with normal glucose and diabetes, respectively (P <0.001). The unadjusted incidence of functional limitation associated with increased levels of CRP and IL-6 was greater among participants with diabetes. After adjusting for clinical and demographic covariates, persistent functional limitation for the highest tertile was greater compared with that for the lowest tertile of CRP or IL-6 for those with and without diabetes. CRP hazard ratios (HRs) were 1.7 (95% CI 1.2-2.3) versus 1.4 (1.1-1.6), respectively. IL-6 HRs were 1.8 (1.3-2.5) versus 1.6 (1.4-2.0), respectively. CONCLUSIONS - In initially high-functioning older adults, those with diabetes and higher inflammatory burden had an increased risk of functional decline. Interventions at early stages to reduce inflammation may preserve function in these individuals.

Original languageEnglish (US)
Pages (from-to)2039-2045
Number of pages7
JournalDiabetes Care
Volume29
Issue number9
DOIs
StatePublished - 2006
Externally publishedYes

Fingerprint

Body Composition
C-Reactive Protein
Interleukin-6
Inflammation
Health
Mobility Limitation
Glucose
Hypoglycemic Agents
Walking
Fasting
Research Design
Demography
Incidence

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Figaro, M. K., Kritchevsky, S. B., Resnick, H. E., Shorr, R. I., Butler, J., Shintani, A., ... Harris, T. B. (2006). Diabetes, inflammation, and functional decline in older adults: Findings from the health, aging and body composition (ABC) study. Diabetes Care, 29(9), 2039-2045. https://doi.org/10.2337/dc06-0245

Diabetes, inflammation, and functional decline in older adults : Findings from the health, aging and body composition (ABC) study. / Figaro, M. Kathleen; Kritchevsky, Stephen B.; Resnick, Helaine E.; Shorr, Ronald I.; Butler, Javed; Shintani, Ayumi; Penninx, Brenda W.; Simonsick, Eleanor Marie; Goodpaster, Bret H.; Newman, Anne B.; Schwartz, Ann V.; Harris, Tamara B.

In: Diabetes Care, Vol. 29, No. 9, 2006, p. 2039-2045.

Research output: Contribution to journalArticle

Figaro, MK, Kritchevsky, SB, Resnick, HE, Shorr, RI, Butler, J, Shintani, A, Penninx, BW, Simonsick, EM, Goodpaster, BH, Newman, AB, Schwartz, AV & Harris, TB 2006, 'Diabetes, inflammation, and functional decline in older adults: Findings from the health, aging and body composition (ABC) study', Diabetes Care, vol. 29, no. 9, pp. 2039-2045. https://doi.org/10.2337/dc06-0245
Figaro, M. Kathleen ; Kritchevsky, Stephen B. ; Resnick, Helaine E. ; Shorr, Ronald I. ; Butler, Javed ; Shintani, Ayumi ; Penninx, Brenda W. ; Simonsick, Eleanor Marie ; Goodpaster, Bret H. ; Newman, Anne B. ; Schwartz, Ann V. ; Harris, Tamara B. / Diabetes, inflammation, and functional decline in older adults : Findings from the health, aging and body composition (ABC) study. In: Diabetes Care. 2006 ; Vol. 29, No. 9. pp. 2039-2045.
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T1 - Diabetes, inflammation, and functional decline in older adults

T2 - Findings from the health, aging and body composition (ABC) study

AU - Figaro, M. Kathleen

AU - Kritchevsky, Stephen B.

AU - Resnick, Helaine E.

AU - Shorr, Ronald I.

AU - Butler, Javed

AU - Shintani, Ayumi

AU - Penninx, Brenda W.

AU - Simonsick, Eleanor Marie

AU - Goodpaster, Bret H.

AU - Newman, Anne B.

AU - Schwartz, Ann V.

AU - Harris, Tamara B.

PY - 2006

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N2 - OBJECTIVE - Age, diabetes, and elevated inflammatory markers independently increase the risk of functional decline. We examined the effect of C-reactive protein (CRP) and interleukin-6 (IL-6) on the incident mobility limitation in older adults with and without diabetes. RESEARCH DESIGN AND METHODS - We analyzed data from a cohort of 2,895 well-functioning adults aged 70-79 years, followed for development of persistent functional limitation over 3.5 years. Participants were assessed for the presence of diabetes according to fasting glucose and/or hypoglycemic medication use and were divided into three equal groups (tertiles) according to level of CRP or IL-6. Persistent functional limitation was defined as difficulty climbing 10 steps or walking one-quarter mile on two consecutive semiannual assessments. RESULTS - At baseline, 702 participants (24%) had diabetes. CRP values were (median ± SD) 2.8 ± 4.4 versus 3.7 ± 5.4 for those with normal glucose and diabetes, respectively (P <0.001). The unadjusted incidence of functional limitation associated with increased levels of CRP and IL-6 was greater among participants with diabetes. After adjusting for clinical and demographic covariates, persistent functional limitation for the highest tertile was greater compared with that for the lowest tertile of CRP or IL-6 for those with and without diabetes. CRP hazard ratios (HRs) were 1.7 (95% CI 1.2-2.3) versus 1.4 (1.1-1.6), respectively. IL-6 HRs were 1.8 (1.3-2.5) versus 1.6 (1.4-2.0), respectively. CONCLUSIONS - In initially high-functioning older adults, those with diabetes and higher inflammatory burden had an increased risk of functional decline. Interventions at early stages to reduce inflammation may preserve function in these individuals.

AB - OBJECTIVE - Age, diabetes, and elevated inflammatory markers independently increase the risk of functional decline. We examined the effect of C-reactive protein (CRP) and interleukin-6 (IL-6) on the incident mobility limitation in older adults with and without diabetes. RESEARCH DESIGN AND METHODS - We analyzed data from a cohort of 2,895 well-functioning adults aged 70-79 years, followed for development of persistent functional limitation over 3.5 years. Participants were assessed for the presence of diabetes according to fasting glucose and/or hypoglycemic medication use and were divided into three equal groups (tertiles) according to level of CRP or IL-6. Persistent functional limitation was defined as difficulty climbing 10 steps or walking one-quarter mile on two consecutive semiannual assessments. RESULTS - At baseline, 702 participants (24%) had diabetes. CRP values were (median ± SD) 2.8 ± 4.4 versus 3.7 ± 5.4 for those with normal glucose and diabetes, respectively (P <0.001). The unadjusted incidence of functional limitation associated with increased levels of CRP and IL-6 was greater among participants with diabetes. After adjusting for clinical and demographic covariates, persistent functional limitation for the highest tertile was greater compared with that for the lowest tertile of CRP or IL-6 for those with and without diabetes. CRP hazard ratios (HRs) were 1.7 (95% CI 1.2-2.3) versus 1.4 (1.1-1.6), respectively. IL-6 HRs were 1.8 (1.3-2.5) versus 1.6 (1.4-2.0), respectively. CONCLUSIONS - In initially high-functioning older adults, those with diabetes and higher inflammatory burden had an increased risk of functional decline. Interventions at early stages to reduce inflammation may preserve function in these individuals.

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