{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T07:35:11Z","timestamp":1793086511133,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2012,8,10]],"date-time":"2012-08-10T00:00:00Z","timestamp":1344556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2012,9]]},"abstract":"\n Objectives<\/jats:title>\n To determine the degree to which hyperglycemia predicts the development of frailty and lower extremity mobility limitations.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Secondary data analysis of longitudinal data collected in a prospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n \n B<\/jats:styled-content>\n altimore,\n M<\/jats:styled-content>\n aryland.\n <\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n \n Three hundred twenty\u2010nine women from the\n W<\/jats:styled-content>\n omen's\n H<\/jats:styled-content>\n ealth and\n A<\/jats:styled-content>\n ging\n S<\/jats:styled-content>\n tudy\n II<\/jats:styled-content>\n aged 70 to 79 at baseline who had all variables needed for analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Measurements<\/jats:title>\n \n Glycosylated hemoglobin (\n H<\/jats:styled-content>\n b\n A<\/jats:styled-content>\n 1c) at baseline, categorized as less than 5.5%, 5.5% to 5.9%, 6.0% to 6.4%, 6.5% to 7.9%, and 8.0% and greater, was the independent variable. The incidence of frailty and lower extremity mobility limitations (based on self\u2010reported walking difficulty, walking speed, and\n S<\/jats:styled-content>\n hort\n P<\/jats:styled-content>\n erformance\n P<\/jats:styled-content>\n hysical\n B<\/jats:styled-content>\n attery score) was determined (follow\u2010up\u00a0\u2248\u00a09\u00a0years). Frailty was assessed using the\n C<\/jats:styled-content>\n ardiovascular\n H<\/jats:styled-content>\n ealth\n S<\/jats:styled-content>\n tudy criteria. Covariates included demographic characteristics, body mass index, interleukin\u20106 level, and clinical history of comorbidities. Statistical analyses included Kaplan\u2013Meier survival curves and Cox regression models adjusted for important covariates.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In time\u2010to\u2010event analyses,\n H<\/jats:styled-content>\n b\n A<\/jats:styled-content>\n 1c category was associated with incidence of walking difficulty (\n P<\/jats:italic>\n \u00a0=\u00a0.049) and low physical performance (\n P<\/jats:italic>\n \u00a0=\u00a0.001); association with incidence of frailty and low walking speed had a trend toward significance (both\n P<\/jats:italic>\n \u00a0=\u00a0.10). In regression models adjusted for demographic characteristics,\n H<\/jats:styled-content>\n b\n A<\/jats:styled-content>\n 1c of 8.0% or greater (vs <\u00a05.5%) was associated with an approximately three\u2010times greater risk of incident frailty and three to five times greater risk of lower extremity mobility limitations (all\n P<\/jats:italic>\n \u00a0<\u00a0.05). In fully adjusted models,\n H<\/jats:styled-content>\n b\n A<\/jats:styled-content>\n 1c of 8.0% or greater (vs <\u00a05.5%) was associated with incident frailty (hazard ratio (\n HR<\/jats:styled-content>\n )\u00a0=\u00a03.33, 95% confidence interval (\n CI<\/jats:styled-content>\n )\u00a0=\u00a01.24\u20138.93), walking difficulty (\n HR<\/jats:styled-content>\n \u00a0=\u00a03.47, 95%\n CI<\/jats:styled-content>\n \u00a0=\u00a01.26\u20139.55), low walking speed (\n HR<\/jats:styled-content>\n \u00a0=\u00a02.82, 95%\n CI<\/jats:styled-content>\n \u00a0=\u00a01.19\u20136.71), and low physical performance (\n HR<\/jats:styled-content>\n \u00a0=\u00a03.60, 95%\n CI<\/jats:styled-content>\n \u00a0=\u00a01.52\u20138.53).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Hyperglycemia is associated with the development of frailty and lower extremity mobility limitations in older women. Future studies should identify mediators of these relationships.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/j.1532-5415.2012.04099.x","type":"journal-article","created":{"date-parts":[[2012,8,10]],"date-time":"2012-08-10T11:12:54Z","timestamp":1344597174000},"page":"1701-1707","source":"Crossref","is-referenced-by-count":136,"title":["Hyperglycemia and Incidence of Frailty and Lower Extremity Mobility Limitations in Older Women"],"prefix":"10.1111","volume":"60","author":[{"given":"Rita R.","family":"Kalyani","sequence":"first","affiliation":[{"name":"Divisions of Endocrinology Johns Hopkins University Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Tian","sequence":"additional","affiliation":[{"name":"Geriatric Medicine and Gerontology Johns Hopkins University Baltimore Maryland"},{"name":"Center on Aging and Health Johns Hopkins University Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian\u2010Li","family":"Xue","sequence":"additional","affiliation":[{"name":"Geriatric Medicine and Gerontology Johns Hopkins University Baltimore Maryland"},{"name":"Center on Aging and Health Johns Hopkins University Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Walston","sequence":"additional","affiliation":[{"name":"Geriatric Medicine and Gerontology Johns Hopkins University Baltimore Maryland"},{"name":"Center on Aging and Health Johns Hopkins University Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne R.","family":"Cappola","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda P.","family":"Fried","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Mailman School of Public Health Columbia University New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick L.","family":"Brancati","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Johns Hopkins University Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline S.","family":"Blaum","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine University of Michigan Ann Arbor Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,8,10]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-1296"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.5.1047"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.1.70"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-1597"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/56.3.M146"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/61.3.262"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.20.2333"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glr141"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2009.02196.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.7.635"},{"key":"e_1_2_6_12_1","doi-asserted-by":"crossref","first-page":"M43","DOI":"10.1093\/gerona\/55.1.M43","article-title":"Preclinical mobility disability predicts incident mobility disability in older women","volume":"55","author":"Fried LP","year":"2000","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronj\/49.2.M85"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/55.4.M221"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1532-5415.2003.51104.x"},{"key":"e_1_2_6_16_1","volume-title":"Obesity: Preventing and Managing the Global Epidemic. 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