title: Low Hemoglobin A1c Increases the Risk of Disability in Community-dwelling Older Non-diabetics Adults.
abstract: OBJECTIVE
  To describe the health characteristics of individuals with low HbA1c levels and evaluate the association between HbA1c level and disability or all-cause mortality in non-diabetic older adults.
  
  
  METHODS
  Prospective observational cohort study.
  
  
  METHODS
  Seongnam, Gyeongi Province, Korea.
  
  
  METHODS
  Among the 1,000 community-dwelling Koreans ≥ 65 years of age who were followed for 5 years, 760 non-diabetic individuals were analyzed.
  
  
  METHODS
  Activities of Daily Living (ADL) and Instrumental ADL (IADL) were evaluated and mortality data were obtained from the National Statistics Office of Korea.
  
  
  RESULTS
  The mean age was 76.3 (SD 9.0) years, and 319 subjects (42.0%) were male. Lower level of HbA1c was associated with less frequent hypertension and less frequent use of aspirin or statin, and lower values of body mass index, hematocrit, total iron-binding capacity, albumin, and cholesterol level. The participants were categorized into 3 groups according to their HbA1c (group I, < 5.5%; group II, 5.5~5.9%; and group III, 6.0 ~ 6.4%). Although, there was no significant difference in functional status according to baseline HbA1c level, disability was more frequently observed as the HbA1c level decrease (18.3% in group I, 12.5% in group II, and 5.3% in group III, p=0.029) at the 5-year follow-up evaluation. There were 172 deaths (22.6%) during the follow-up period. There was no significant difference in mortality among the groups, however, group I had a 2.071-fold higher risk for the incident disability or mortality over group III after adjusting age, gender, and possible confounder (95% CI: 1.040 ~ 4.124, p=0.038).
  
  
  CONCLUSIONS
  Lower level of HbA1c was associated with an increased risk of disability in non-diabetic older adults.
authors.affiliation: Ho Jun Chin, MD, PhD, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gumi-ro 166, Bundang-gu, Seongnam-si, Kyeongi-do, 463-707, Republic of Korea, E-mail: mednep@snubh.org, Telephone: 82-31-787-7025, Fax: 82-31-787-4052.
authors.forename: K-I
authors.initials: KI
authors.lastname: Kim
authors.forename: S
authors.initials: S
authors.lastname: Kim
authors.forename: K-W
authors.initials: KW
authors.lastname: Kim
authors.forename: H-C
authors.initials: HC
authors.lastname: Jang
authors.forename: C-H
authors.initials: CH
authors.lastname: Kim
authors.forename: H J
authors.initials: HJ
authors.lastname: Chin
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D015992:Body Mass Index; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D009026:Mortality; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D012306:Risk
chemical_list: D006442:Glycated Hemoglobin