Diabetes-Related Complications, Glycemic Control, and Falls in Older Adults
OBJECTIVE:--Older adults with type 2 diabetes are more likely to fall, but little is known about risk factors for falls in this population. We determined whether diabetes-related complications or treatments are associated with risk of falls in older diabetic adults. RESEARCH DESIGN AND METHODS--In t...
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| Veröffentlicht in: | Diabetes care 2008-03, Vol.31 (3), p.391-396 |
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| creator | Schwartz, Ann V Vittinghoff, Eric Sellmeyer, Deborah E Feingold, Kenneth R Rekeneire, Nathalie de Strotmeyer, Elsa S Shorr, Ronald I Vinik, Aaron I Odden, Michelle C Park, Seok Won Faulkner, Kimberly A Harris, Tamara B |
| description | OBJECTIVE:--Older adults with type 2 diabetes are more likely to fall, but little is known about risk factors for falls in this population. We determined whether diabetes-related complications or treatments are associated with risk of falls in older diabetic adults. RESEARCH DESIGN AND METHODS--In the Health, Aging, and Body Composition cohort of well-functioning older adults, participants reported falls in the previous year at annual visits. Odds ratios (ORs) for more frequent falls among 446 diabetic participants whose mean age was 73.6 years, with an average follow-up of 4.9 years, were estimated with continuation ratio models. RESULTS:--In the first year, 24% reported falling; 22, 26, 31, and 30% fell in subsequent years. In adjusted models, reduced peroneal nerve response amplitude (OR 1.50 -95% CI 1.07-2.12], worst quartile versus others); higher cystatin-C, a marker of reduced renal function (1.38 [1.11-1.71], for 1 SD increase); poorer contrast sensitivity (1.41 [0.97-2.04], worst quartile versus others); and low A1C in insulin users (4.36 [1.32-14.46], A1C 8%) were associated with risk of falls. In those using oral hypoglycemic medications but not insulin, low A1C was not associated with risk of falls (1.29 [0.65-2.54], A1C 8%). Adjustment for physical performance explained some, but not all, of these associations. CONCLUSIONS:--In older diabetic adults, reducing diabetes-related complications may prevent falls. Achieving lower A1C levels with oral hypoglycemic medications was not associated with more frequent falls, but, among those using insulin, A1C |
| doi_str_mv | 10.2337/dc07-1152 |
| format | Article |
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We determined whether diabetes-related complications or treatments are associated with risk of falls in older diabetic adults. RESEARCH DESIGN AND METHODS--In the Health, Aging, and Body Composition cohort of well-functioning older adults, participants reported falls in the previous year at annual visits. Odds ratios (ORs) for more frequent falls among 446 diabetic participants whose mean age was 73.6 years, with an average follow-up of 4.9 years, were estimated with continuation ratio models. RESULTS:--In the first year, 24% reported falling; 22, 26, 31, and 30% fell in subsequent years. In adjusted models, reduced peroneal nerve response amplitude (OR 1.50 -95% CI 1.07-2.12], worst quartile versus others); higher cystatin-C, a marker of reduced renal function (1.38 [1.11-1.71], for 1 SD increase); poorer contrast sensitivity (1.41 [0.97-2.04], worst quartile versus others); and low A1C in insulin users (4.36 [1.32-14.46], A1C <=6 vs. >8%) were associated with risk of falls. In those using oral hypoglycemic medications but not insulin, low A1C was not associated with risk of falls (1.29 [0.65-2.54], A1C <=6 vs. >8%). Adjustment for physical performance explained some, but not all, of these associations. CONCLUSIONS:--In older diabetic adults, reducing diabetes-related complications may prevent falls. Achieving lower A1C levels with oral hypoglycemic medications was not associated with more frequent falls, but, among those using insulin, A1C <=6% increased risk of falls.</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/dc07-1152</identifier><identifier>PMID: 18056893</identifier><identifier>CODEN: DICAD2</identifier><language>eng</language><publisher>Alexandria, VA: American Diabetes Association</publisher><subject>Accidental Falls - prevention & control ; Accidental Falls - statistics & numerical data ; Adults ; Age Factors ; Aged ; Biological and medical sciences ; Blood Glucose - metabolism ; Cohort Studies ; Diabetes ; Diabetes Complications - blood ; Diabetes Complications - prevention & control ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes therapy ; Diabetes. Impaired glucose tolerance ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Falls ; Female ; Follow-Up Studies ; Glycated Hemoglobin A - metabolism ; Humans ; Hypoglycemic Agents - adverse effects ; Hypoglycemic Agents - therapeutic use ; Insulin - adverse effects ; Insulin - therapeutic use ; Male ; Medical sciences ; Metabolic diseases ; Miscellaneous ; Odds Ratio ; Older people ; Physiological aspects ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Risk Factors ; Studies ; Type 2 diabetes</subject><ispartof>Diabetes care, 2008-03, Vol.31 (3), p.391-396</ispartof><rights>2008 INIST-CNRS</rights><rights>COPYRIGHT 2008 American Diabetes Association</rights><rights>Copyright American Diabetes Association Mar 2008</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c631t-79c5dbbd00957b05ec2faed6910c37886cd2d94fefc89233a8db8e9c5a2498423</citedby><cites>FETCH-LOGICAL-c631t-79c5dbbd00957b05ec2faed6910c37886cd2d94fefc89233a8db8e9c5a2498423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20162681$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18056893$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schwartz, Ann V</creatorcontrib><creatorcontrib>Vittinghoff, Eric</creatorcontrib><creatorcontrib>Sellmeyer, Deborah E</creatorcontrib><creatorcontrib>Feingold, Kenneth R</creatorcontrib><creatorcontrib>Rekeneire, Nathalie de</creatorcontrib><creatorcontrib>Strotmeyer, Elsa S</creatorcontrib><creatorcontrib>Shorr, Ronald I</creatorcontrib><creatorcontrib>Vinik, Aaron I</creatorcontrib><creatorcontrib>Odden, Michelle C</creatorcontrib><creatorcontrib>Park, Seok Won</creatorcontrib><creatorcontrib>Faulkner, Kimberly A</creatorcontrib><creatorcontrib>Harris, Tamara B</creatorcontrib><creatorcontrib>Health, Aging, and Body Composition Study</creatorcontrib><creatorcontrib>for the Health, Aging, and Body Composition Study</creatorcontrib><title>Diabetes-Related Complications, Glycemic Control, and Falls in Older Adults</title><title>Diabetes care</title><addtitle>Diabetes Care</addtitle><description>OBJECTIVE:--Older adults with type 2 diabetes are more likely to fall, but little is known about risk factors for falls in this population. We determined whether diabetes-related complications or treatments are associated with risk of falls in older diabetic adults. RESEARCH DESIGN AND METHODS--In the Health, Aging, and Body Composition cohort of well-functioning older adults, participants reported falls in the previous year at annual visits. Odds ratios (ORs) for more frequent falls among 446 diabetic participants whose mean age was 73.6 years, with an average follow-up of 4.9 years, were estimated with continuation ratio models. RESULTS:--In the first year, 24% reported falling; 22, 26, 31, and 30% fell in subsequent years. In adjusted models, reduced peroneal nerve response amplitude (OR 1.50 -95% CI 1.07-2.12], worst quartile versus others); higher cystatin-C, a marker of reduced renal function (1.38 [1.11-1.71], for 1 SD increase); poorer contrast sensitivity (1.41 [0.97-2.04], worst quartile versus others); and low A1C in insulin users (4.36 [1.32-14.46], A1C <=6 vs. >8%) were associated with risk of falls. In those using oral hypoglycemic medications but not insulin, low A1C was not associated with risk of falls (1.29 [0.65-2.54], A1C <=6 vs. >8%). Adjustment for physical performance explained some, but not all, of these associations. CONCLUSIONS:--In older diabetic adults, reducing diabetes-related complications may prevent falls. Achieving lower A1C levels with oral hypoglycemic medications was not associated with more frequent falls, but, among those using insulin, A1C <=6% increased risk of falls.</description><subject>Accidental Falls - prevention & control</subject><subject>Accidental Falls - statistics & numerical data</subject><subject>Adults</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Blood Glucose - metabolism</subject><subject>Cohort Studies</subject><subject>Diabetes</subject><subject>Diabetes Complications - blood</subject><subject>Diabetes Complications - prevention & control</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetes therapy</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Falls</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glycated Hemoglobin A - metabolism</subject><subject>Humans</subject><subject>Hypoglycemic Agents - adverse effects</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Insulin - adverse effects</subject><subject>Insulin - therapeutic use</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metabolic diseases</subject><subject>Miscellaneous</subject><subject>Odds Ratio</subject><subject>Older people</subject><subject>Physiological aspects</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Risk Factors</subject><subject>Studies</subject><subject>Type 2 diabetes</subject><issn>0149-5992</issn><issn>1935-5548</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptkl1rFDEUhoModlu98A_oIPRC6NR8TGaSG2FZbRULBbXXIZOc2U3JJttkVum_N8MOrULJRcLJc95z3pwg9Ibgc8pY99Ea3NWEcPoMLYhkvOa8Ec_RApNG1lxKeoSOc77FGDeNEC_RERGYt0KyBfr-2ekeRsj1D_B6BFut4nbnndGjiyGfVZf-3sDWmRIPY4r-rNLBVhfa-1y5UF17C6la2r0f8yv0YtA-w-t5P0E3F19-rb7WV9eX31bLq9q0jIx1Jw23fW8xlrzrMQdDBw22lQQb1gnRGkutbAYYjJDFnxa2F1CSNG2kaCg7QZ8Ourt9vwVroDSmvdolt9XpXkXt1P83wW3UOv5WlArBG1kE3s8CKd7tIY_qNu5TKD0XhGFKpBQFqg_QWntQLgyxaJk1BCiSMcDgSnhJulaQ4qMp_PkTfFl2er4nEz4cEkyKOScYHhwQrKa5qmmuapprYd_-a_mRnAdZgNMZ0NloPyQdjMsPHMWkpaXwY9GNW2_-uATKzh9gOhhdAowoppic2HcHdtBR6XUqejc_ixLDWLS8wx37Cy1uwVU</recordid><startdate>20080301</startdate><enddate>20080301</enddate><creator>Schwartz, Ann V</creator><creator>Vittinghoff, Eric</creator><creator>Sellmeyer, Deborah E</creator><creator>Feingold, Kenneth R</creator><creator>Rekeneire, Nathalie de</creator><creator>Strotmeyer, Elsa S</creator><creator>Shorr, Ronald I</creator><creator>Vinik, Aaron I</creator><creator>Odden, Michelle C</creator><creator>Park, Seok Won</creator><creator>Faulkner, Kimberly A</creator><creator>Harris, Tamara B</creator><general>American Diabetes Association</general><scope>FBQ</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0K</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>S0X</scope><scope>5PM</scope></search><sort><creationdate>20080301</creationdate><title>Diabetes-Related Complications, Glycemic Control, and Falls in Older Adults</title><author>Schwartz, Ann V ; Vittinghoff, Eric ; Sellmeyer, Deborah E ; Feingold, Kenneth R ; Rekeneire, Nathalie de ; Strotmeyer, Elsa S ; Shorr, Ronald I ; Vinik, Aaron I ; Odden, Michelle C ; Park, Seok Won ; Faulkner, Kimberly A ; Harris, Tamara B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c631t-79c5dbbd00957b05ec2faed6910c37886cd2d94fefc89233a8db8e9c5a2498423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Accidental Falls - prevention & control</topic><topic>Accidental Falls - statistics & numerical data</topic><topic>Adults</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Blood Glucose - metabolism</topic><topic>Cohort Studies</topic><topic>Diabetes</topic><topic>Diabetes Complications - blood</topic><topic>Diabetes Complications - prevention & control</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Diabetes therapy</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Falls</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glycated Hemoglobin A - metabolism</topic><topic>Humans</topic><topic>Hypoglycemic Agents - adverse effects</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Insulin - adverse effects</topic><topic>Insulin - therapeutic use</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metabolic diseases</topic><topic>Miscellaneous</topic><topic>Odds Ratio</topic><topic>Older people</topic><topic>Physiological aspects</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Risk Factors</topic><topic>Studies</topic><topic>Type 2 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schwartz, Ann V</creatorcontrib><creatorcontrib>Vittinghoff, Eric</creatorcontrib><creatorcontrib>Sellmeyer, Deborah E</creatorcontrib><creatorcontrib>Feingold, Kenneth R</creatorcontrib><creatorcontrib>Rekeneire, Nathalie de</creatorcontrib><creatorcontrib>Strotmeyer, Elsa S</creatorcontrib><creatorcontrib>Shorr, Ronald I</creatorcontrib><creatorcontrib>Vinik, Aaron I</creatorcontrib><creatorcontrib>Odden, Michelle C</creatorcontrib><creatorcontrib>Park, Seok Won</creatorcontrib><creatorcontrib>Faulkner, Kimberly A</creatorcontrib><creatorcontrib>Harris, Tamara B</creatorcontrib><creatorcontrib>Health, Aging, and Body Composition Study</creatorcontrib><creatorcontrib>for the Health, Aging, and Body Composition 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Participant titles)</collection><jtitle>Diabetes care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schwartz, Ann V</au><au>Vittinghoff, Eric</au><au>Sellmeyer, Deborah E</au><au>Feingold, Kenneth R</au><au>Rekeneire, Nathalie de</au><au>Strotmeyer, Elsa S</au><au>Shorr, Ronald I</au><au>Vinik, Aaron I</au><au>Odden, Michelle C</au><au>Park, Seok Won</au><au>Faulkner, Kimberly A</au><au>Harris, Tamara B</au><aucorp>Health, Aging, and Body Composition Study</aucorp><aucorp>for the Health, Aging, and Body Composition Study</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diabetes-Related Complications, Glycemic Control, and Falls in Older Adults</atitle><jtitle>Diabetes care</jtitle><addtitle>Diabetes Care</addtitle><date>2008-03-01</date><risdate>2008</risdate><volume>31</volume><issue>3</issue><spage>391</spage><epage>396</epage><pages>391-396</pages><issn>0149-5992</issn><eissn>1935-5548</eissn><coden>DICAD2</coden><abstract>OBJECTIVE:--Older adults with type 2 diabetes are more likely to fall, but little is known about risk factors for falls in this population. We determined whether diabetes-related complications or treatments are associated with risk of falls in older diabetic adults. RESEARCH DESIGN AND METHODS--In the Health, Aging, and Body Composition cohort of well-functioning older adults, participants reported falls in the previous year at annual visits. Odds ratios (ORs) for more frequent falls among 446 diabetic participants whose mean age was 73.6 years, with an average follow-up of 4.9 years, were estimated with continuation ratio models. RESULTS:--In the first year, 24% reported falling; 22, 26, 31, and 30% fell in subsequent years. In adjusted models, reduced peroneal nerve response amplitude (OR 1.50 -95% CI 1.07-2.12], worst quartile versus others); higher cystatin-C, a marker of reduced renal function (1.38 [1.11-1.71], for 1 SD increase); poorer contrast sensitivity (1.41 [0.97-2.04], worst quartile versus others); and low A1C in insulin users (4.36 [1.32-14.46], A1C <=6 vs. >8%) were associated with risk of falls. In those using oral hypoglycemic medications but not insulin, low A1C was not associated with risk of falls (1.29 [0.65-2.54], A1C <=6 vs. >8%). Adjustment for physical performance explained some, but not all, of these associations. CONCLUSIONS:--In older diabetic adults, reducing diabetes-related complications may prevent falls. Achieving lower A1C levels with oral hypoglycemic medications was not associated with more frequent falls, but, among those using insulin, A1C <=6% increased risk of falls.</abstract><cop>Alexandria, VA</cop><pub>American Diabetes Association</pub><pmid>18056893</pmid><doi>10.2337/dc07-1152</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0149-5992 |
| ispartof | Diabetes care, 2008-03, Vol.31 (3), p.391-396 |
| issn | 0149-5992 1935-5548 |
| language | eng |
| recordid | cdi_pubmed_primary_18056893 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Accidental Falls - prevention & control Accidental Falls - statistics & numerical data Adults Age Factors Aged Biological and medical sciences Blood Glucose - metabolism Cohort Studies Diabetes Diabetes Complications - blood Diabetes Complications - prevention & control Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - drug therapy Diabetes therapy Diabetes. Impaired glucose tolerance Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Falls Female Follow-Up Studies Glycated Hemoglobin A - metabolism Humans Hypoglycemic Agents - adverse effects Hypoglycemic Agents - therapeutic use Insulin - adverse effects Insulin - therapeutic use Male Medical sciences Metabolic diseases Miscellaneous Odds Ratio Older people Physiological aspects Public health. Hygiene Public health. Hygiene-occupational medicine Risk Factors Studies Type 2 diabetes |
| title | Diabetes-Related Complications, Glycemic Control, and Falls in Older Adults |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-13T12%3A41%3A52IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Diabetes-Related%20Complications,%20Glycemic%20Control,%20and%20Falls%20in%20Older%20Adults&rft.jtitle=Diabetes%20care&rft.au=Schwartz,%20Ann%20V&rft.aucorp=Health,%20Aging,%20and%20Body%20Composition%20Study&rft.date=2008-03-01&rft.volume=31&rft.issue=3&rft.spage=391&rft.epage=396&rft.pages=391-396&rft.issn=0149-5992&rft.eissn=1935-5548&rft.coden=DICAD2&rft_id=info:doi/10.2337/dc07-1152&rft_dat=%3Cgale_pubme%3EA176819574%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=223021998&rft_id=info:pmid/18056893&rft_galeid=A176819574&rfr_iscdi=true |