Advanced glycated end products (AGEs) accumulate systemically and cause diabetes complications. However, whether noninvasive measurable AGEs are associated with diabetes status and physical functions remains unclear. One hundred and ten patients with cardiovascular disease (CVD) who underwent outpatient cardiac rehabilitation were included. AGEs scores, using AGEs sensors, were evaluated concomitantly with a physical evaluation, including testing the isometric knee extension strength (IKES) and 6 min walking distance (6MWD). Thirty-three (30%) patients had a history of diabetes mellitus (DM). The AGEs score was not different in the presence of DM history (0.52 ± 0.09 vs. 0.51 ± 0.09, p = 0.768) and was not correlated with blood glucose (r = 0.001, p = 0.995). The AGEs score was positively correlated with hemoglobin A1c (HbA1c, r = 0.288, p = 0.004) and negatively correlated with physical functions (IKES, r = −0.243, p = 0.011; 6MWD, r = −0.298, p = 0.002). The multivariate analysis demonstrated that 6MWD was independently associated with a high AGEs score (>0.52). The AGEs score was associated with HbA1c, IKES, and 6MWD in patients with CVD. The AGEs score might be a useful indicator for evaluating not only glycemic control but also physical functions.
Purpose
Walking speed is a useful predictor of hospitalization for community-dwelling older people. However, whether it is an effective predictor for disabled community-dwelling older people has not been clarified. This study aimed to investigate the association of walking speed with unexpected hospitalizations in community-dwelling older people with disabilities.
Methods
The participants were ambulatory, community-dwelling, older adults aged 65 years or older with disability. Comfortable and maximum walking speeds were measured at two time points, baseline and 3 months later. Furthermore, the change over time at 3 months in walking speed was also calculated. If the change in walking speed decreased more than 0.1 m/s, it was defined as walking speed decreased. The primary outcome was unexpected hospitalization during 4-year follow-up. The associations among baseline walking speed, walking speed decline, and hospitalization were analyzed using Cox regression analysis adjusted for potential confounding factors.
Results
Ninety-three people were included, and unexpected hospitalization occurred in 47 people during 4-year follow-up. On Cox regression analysis adjusted for potential confounding factors, only the maximum walking speed decrease was significantly associated with hospitalization (Hazard ratio = 2.53, 95% confidence interval: 1.23–5.21], but not baseline walking speed and comfortable walking speed decrease.
Conclusion
As for the assessment of walking speed for prediction of unexpected hospitalization in disabled older people, measurement at a single time point is not useful, whereas change over time is. Monitoring of change over time in maximum walking speed appears to be one of the indicators for the health management of disabled older people.
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