Relationship between HbA1c and all-cause mortality in older patients with insulin-treated type 2 diabetes: results of a large UK Cohort Study.

Abstract:

BACKGROUND:our aim was to study the relationship between HbA1c and cardiovascular morbidity and all-cause mortality among older insulin-treated patients with type 2 diabetes (T2D) after adjustment for multiple confounders. METHODS:data for 4589 adults with T2D (>65 years) on insulin treatment were sourced from 532 UK General Practices via the Health Improvement Network (THIN) database. Cox proportional hazard models and Kaplan-Meier estimators were fitted to derive the hazards of all-cause mortality by HbA1c categories (<6.5, 6.5-7.4, 7.5-8.4, 8.5-9.4, 9.5-10.4, 10.5-11.4%; and 11.5% and above) after 5 years of follow-up following insulin initiation. RESULTS:we observed a U-shaped relationship between all-cause mortality and HbA1c, with the lowest risk seen in the HbA1c range of 6.5-7.4% and marked increased in risk with HbA1c > 11%. The highest mortality risks of 31 and 40% were significantly associated with the lowest (<6.5%) and highest (11.5% and above) HbA1c categories: aHR: 1.31; (95%CI: 1.10-1.56; P = 0.002) and aHR: 1.40; (95%CI: 1.01-1.96; P = 0.039), respectively. CONCLUSIONS:both low and high HbA1c were associated with increased all-cause mortality, among older patients with insulin-treated T2D. This cohort study supports the need for individualisation of care and suggests better outcomes with HbA1c levels around 6.5-7.4% and markedly excess risk with HbA1c > 11.

journal_name

Age Ageing

journal_title

Age and ageing

authors

Anyanwagu U,Mamza J,Donnelly R,Idris I

doi

10.1093/ageing/afy178

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

235-240

issue

2

eissn

0002-0729

issn

1468-2834

pii

5274641

journal_volume

48

pub_type

杂志文章
  • Spindle cell sarcoma: a rare cause of a large abdominal mass.

    abstract::A 73-year-old man presented with a huge intra-abdominal mass. Initially a gastrointestinal stromal tumour (GIST) was diagnosed, but his tumour was subsequently classified as a spindle cell sarcoma. Difficulties in the classification of rare intra-abdominal tumours are discussed. ...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afi002

    authors: Bills V,Iqbal R,Haqqani M,Clague JE

    更新日期:2005-01-01 00:00:00

  • Impairments in hearing and vision impact on mortality in older people: the AGES-Reykjavik Study.

    abstract:OBJECTIVE:to examine the relationships between impairments in hearing and vision and mortality from all-causes and cardiovascular disease (CVD) among older people. DESIGN:population-based cohort study. PARTICIPANTS:the study population included 4,926 Icelandic individuals, aged ≥67 years, 43.4% male, who completed vi...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/aft122

    authors: Fisher D,Li CM,Chiu MS,Themann CL,Petersen H,Jónasson F,Jónsson PV,Sverrisdottir JE,Garcia M,Harris TB,Launer LJ,Eiriksdottir G,Gudnason V,Hoffman HJ,Cotch MF

    更新日期:2014-01-01 00:00:00

  • Dual-task effects of talking while walking on velocity and balance following a stroke.

    abstract:BACKGROUND:Therapists and nurses often use verbal instruction in the rehabilitation of mobility following stroke. This study aimed to determine whether performing a verbal cognitive task while walking adversely affected patients' balance and velocity. METHODS:There were two counterbalanced conditions: walking only and...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/30.4.319

    authors: Bowen A,Wenman R,Mickelborough J,Foster J,Hill E,Tallis R

    更新日期:2001-07-01 00:00:00

  • Confidentiality and cognitive impairment: professional and philosophical ethics.

    abstract::In the UK, the General Medical Council's new guidance on confidentiality restates the professional duty for doctors to regard personal information revealed to them as confidential. Such information can be shared only with the patient's explicit consent--the exceptions to this are narrowly defined. We believe the guida...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/31.2.147

    authors: Hughes JC,Louw SJ

    更新日期:2002-03-01 00:00:00

  • A multifactorial intervention for the prevention of falls in psychogeriatric nursing home patients, a randomised controlled trial (RCT).

    abstract:OBJECTIVE:to evaluate the effectiveness of a multifactorial intervention on incidence of falls in psychogeriatric nursing home patients. DESIGN:cluster-randomised controlled 12-month trial. SETTING:psychogeriatric wards in 12 nursing homes in The Netherlands. PARTICIPANTS:psychogeriatric nursing home patients (n = 5...

    journal_title:Age and ageing

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/ageing/afn297

    authors: Neyens JC,Dijcks BP,Twisk J,Schols JM,van Haastregt JC,van den Heuvel WJ,de Witte LP

    更新日期:2009-03-01 00:00:00

  • Economic evaluation of the differential benefits of home visits with telephone calls and telephone calls only in transitional discharge support.

    abstract:BACKGROUND:home visits and telephone calls are two often used approaches in transitional care, but their differential economic effects are unknown. OBJECTIVE:to examine the differential economic benefits of home visits with telephone calls and telephone calls only in transitional discharge support. DESIGN:cost-effect...

    journal_title:Age and ageing

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/ageing/afu166

    authors: Wong FK,So C,Chau J,Law AK,Tam SK,McGhee S

    更新日期:2015-01-01 00:00:00

  • Unexpected paracetamol (acetaminophen) hepatotoxicity at standard dosage in two older patients: time to rethink 1 g four times daily?

    abstract::We present two cases of acute hepatotoxicity associated with elevated paracetamol (acetaminophen) levels in older patients. Both patients were receiving a standard European dose of oral paracetamol (2 × 500 mg QDS) with no risk factors for slowed metabolism (weight <50 kg, interacting medications, hepatic enzyme induc...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afw067

    authors: Ging P,Mikulich O,O'Reilly KM

    更新日期:2016-07-01 00:00:00

  • Attitudes towards the care of the aged and to a career with elderly patients among students attached to a geriatric and general medical firm.

    abstract::Studies in the United States have suggested that medical students' bias against older patients is not influenced by ad hoc courses in geriatrics. If the suggestion is correct then there should be no difference between the attitudes towards the care of the aged and to a career with elderly patients among students attac...

    journal_title:Age and ageing

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/ageing/11.3.196

    authors: Peach H,Pathy MS

    更新日期:1982-08-01 00:00:00

  • Effects of functional tasks exercise on older adults with cognitive impairment at risk of Alzheimer's disease: a randomised controlled trial.

    abstract:OBJECTIVE:the aim of this study was to compare the effects of a functional tasks exercise programme to a cognitive training programme in older adults with mild cognitive impairment. DESIGN:a single-blind randomised control trial with the intervention group compared with an active control group. SETTING:out-patient cl...

    journal_title:Age and ageing

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/ageing/afu055

    authors: Law LL,Barnett F,Yau MK,Gray MA

    更新日期:2014-11-01 00:00:00

  • The social behaviour of geriatric patients at mealtimes: an observational and an intervention study.

    abstract::Two studies of the social behaviour of geriatric patients are reported. In the first, lunchtime observations were made of two comparable wards in a continuing-care hospital and all episodes of social interaction recorded. There were twice as many interactions on one ward as on the other and their type and variety diff...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/9.2.93

    authors: Davies AD,Snaith PA

    更新日期:1980-05-01 00:00:00

  • New horizons in the pathogenesis, assessment and management of delirium.

    abstract:UNLABELLED:Delirium is one of the foremost unmet medical needs in healthcare. It affects one in eight hospitalised patients and is associated with multiple adverse outcomes including increased length of stay, new institutionalisation, and considerable patient distress. Recent studies also show that delirium strongly pr...

    journal_title:Age and ageing

    pub_type: 杂志文章,评审

    doi:10.1093/ageing/aft148

    authors: Maclullich AM,Anand A,Davis DH,Jackson T,Barugh AJ,Hall RJ,Ferguson KJ,Meagher DJ,Cunningham C

    更新日期:2013-11-01 00:00:00

  • Greater progression of athletic performance in older Masters athletes.

    abstract:BACKGROUND:The number of new world records has decreased substantially in most athletic events in recent years. There has been enormous growth in participation at Masters events, and older athletes have been competing at the highest levels with much younger athletes. However, the progression of athletic performance ove...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afv023

    authors: Akkari A,Machin D,Tanaka H

    更新日期:2015-07-01 00:00:00

  • Use of prescription medication in the last years of life: a population-based comparison of two oldest old Danish birth cohorts born 10 years apart.

    abstract:INTRODUCTION:Age limits for diagnostics and treatments have been largely removed and replaced by an active diagnostic and treatment practice among the oldest old and has led to concerns about potential overtreatment during the last years of life. METHODS:Use of prescription medication in the last years of life was ass...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afaa064

    authors: Pedersen JK,Jensen TM,Waldorff FB,Søndergaard J,Christensen K

    更新日期:2020-10-23 00:00:00

  • An evaluation of the efficacy and safety of tetrahydroaminoacridine (THA) without lecithin in the treatment of Alzheimer's disease.

    abstract::Seventy-nine patients with probable Alzheimer's disease were enrolled into a double-blind, placebo-controlled cross-over study to assess the therapeutic effect and safety of THA (tetrahydroaminoacridine; tacrine) without concomitant lecithin administration. Forty-one patients completed the trial which consisted of two...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/22.5.316

    authors: Wilcock GK,Surmon DJ,Scott M,Boyle M,Mulligan K,Neubauer KA,O'Neill D,Royston VH

    更新日期:1993-09-01 00:00:00

  • Social isolation and loneliness as related to progression and reversion of frailty in the Survey of Health Aging Retirement in Europe (SHARE).

    abstract:BACKGROUND:Frailty was shown to be associated with psychosocial risk factors, but there are few longitudinal data. METHODS:We used data from waves 5 and 6 of the Survey of Health Aging Retirement in Europe (SHARE) to study the contribution of loneliness and social isolation to transitions towards frailty defined accor...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afaa168

    authors: Jarach CM,Tettamanti M,Nobili A,D'avanzo B

    更新日期:2021-01-08 00:00:00

  • Informant ratings of cognitive decline of elderly people: relationship to longitudinal change on cognitive tests

    abstract::Formal assessment of cognitive decline with cognitive tests can be difficult, requiring either two measurement points or a comparison of 'hold' with 'don't hold' tests. Informant-based assessment provides an alternative approach because informants can adopt a longitudinal perspective and directly rate cognitive change...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:

    authors: Jorm AF,Christensen H,Henderson AS,Jacomb PA,Korten AE,Mackinnon A

    更新日期:1996-03-01 00:00:00

  • Why do geriatric outpatients have so many moderate and severe vertebral fractures? Exploring prevalence and risk factors.

    abstract:OBJECTIVES:to determine the prevalence of vertebral fractures and their risk factors in geriatric patients. DESIGN:prospective cohort study. SETTING:teaching hospital in Amsterdam, The Netherlands. SUBJECTS:three hundred and three geriatric patients, who had their first visit at a diagnostic day hospital between Apr...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afr174

    authors: van der Jagt-Willems HC,van Hengel M,Vis M,van Munster BC,van Campen JP,Tulner LR,Lems WF

    更新日期:2012-03-01 00:00:00

  • Age-associated change in pain threshold measured by transcutaneous neuronal electrical stimulation.

    abstract::The measurement of cutaneous pain threshold using the Neuromod Selectra Model 7750 Transcutaneous Neuronal Electrical Stimulator is described. Pain threshold, measured in 520 healthy volunteers aged 5-105 years, increased with age. Consistent values were obtained in 22 healthy volunteers on three successive days. Pain...

    journal_title:Age and ageing

    pub_type: 杂志文章,评审

    doi:10.1093/ageing/18.4.241

    authors: Tucker MA,Andrew MF,Ogle SJ,Davison JG

    更新日期:1989-07-01 00:00:00

  • Long-term mortality risks associated with mild anaemia in older persons: the Busselton Health Study.

    abstract:BACKGROUND:up to 25% of older people in the USA and other Western countries are anaemic by World Health Organization (WHO) criteria. The objective of this study was to examine the long-term relationships of haemoglobin concentration with all-cause and cause-specific mortality in a community-based sample of Australian a...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afs150

    authors: Chalmers KA,Knuiman MW,Divitini ML,Bruce DG,Olynyk JK,Milward EA

    更新日期:2012-11-01 00:00:00

  • A longitudinal study of knee pain in older men: Concord Health and Ageing in Men Project.

    abstract:BACKGROUND:chronic knee pain is still considered a fairly benign disease by many, an 'unavoidable' consequence of ageing. This passive acceptance may be unnecessarily exposing older people to disability and serious co-morbidity. The aim of this study was to determine the disease burden associated with chronic knee pain...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/aft188

    authors: Fransen M,Su S,Harmer A,Blyth FM,Naganathan V,Sambrook P,Le Couteur D,Cumming RG

    更新日期:2014-03-01 00:00:00

  • Finding colorectal tumours with an immunological faecal occult blood test in symptomatic primary health care patients.

    abstract::The aim of this prospective study was to investigate whether an immunological double faecal occult blood test (Fecatwin-S/FECA-EIA) can be used in screening patients with symptoms suggestive of colonic or rectal origin in primary health care. Altogether 523 patients were referred to the study by general practitioners....

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/23.5.365

    authors: Kemppainen M,Häkkinen I,Räihä I,Pomoell R,Sourander L

    更新日期:1994-09-01 00:00:00

  • Delay in diagnosis of colorectal cancer in elderly patients.

    abstract::The medical histories of 178 colorectal cancer patients were studied retrospectively from hospital records. The average age at the time of diagnosis was 71 years. Visible loss of blood or anaemia were the commonest features. The mean time from first symptom to first medical consultation was 82.8 days. Men under 65 yea...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/22.4.260

    authors: Kemppainen M,Räihä I,Rajala T,Sourander L

    更新日期:1993-07-01 00:00:00

  • Associations of fat and muscle tissue with cognitive status in older adults: the AGES-Reykjavik Study.

    abstract:Background/Objective:studies on the association of dementia with specific body composition (BC) components are scarce. Our aim was to investigate associations of BC measures with different levels of cognitive function in late-life. Methods:we studied 5,169 participants (mean age 76 years, 42.9% men) in the AGES-Reykja...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afw219

    authors: Spauwen PJ,Murphy RA,Jónsson PV,Sigurdsson S,Garcia ME,Eiriksdottir G,van Boxtel MP,Lopez OL,Gudnason V,Harris TB,Launer LJ

    更新日期:2017-03-01 00:00:00

  • Teaching geriatric medicine to medical students--a summary.

    abstract::Within the wide range of topics embraced in the subject of geriatric medicine, a division may be made as far as teaching is concerned into: 1. those that could be taught by other people; 2. those that should be taught by other people; 3. those that cannot be taught by other people. If attitudes throughout the medical ...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:

    authors: Millard PH

    更新日期:1983-01-01 00:00:00

  • Evaluation of a simulation training programme for geriatric medicine.

    abstract:BACKGROUND:geriatrics encompasses diverse medical, social and ethical challenges requiring a multidimensional, interdisciplinary approach. Recent reports have highlighted failings in the care of older people. It is therefore vital that trainees in geriatrics are afforded opportunities to develop skills in managing this...

    journal_title:Age and ageing

    pub_type: 杂志文章,多中心研究

    doi:10.1093/ageing/afv049

    authors: Braude P,Reedy G,Dasgupta D,Dimmock V,Jaye P,Birns J

    更新日期:2015-07-01 00:00:00

  • Urodynamic studies in the management of urinary incontinence in the elderly.

    abstract::An outline is given of simple urodynamic investigations applicable to elderly subjects. The type of patient presenting primarily to geriatric departments with urinary incontinence, whose management is aided by such studies, is described under various clinical groupings. The requirement for urodynamic studies and the b...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/8.1.41

    authors: Eastwood HD

    更新日期:1979-02-01 00:00:00

  • The factors associated with self-reported physical activity in older adults living in the community.

    abstract:BACKGROUND:despite the vast literature in the area, few studies examined the large range of factors associated with physical activity (PA) in the older adult collectively, information that could help develop a supportive culture for healthy ageing. OBJECTIVE:to identify the socio-demographic, social connectedness, phy...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afv042

    authors: McKee G,Kearney PM,Kenny RA

    更新日期:2015-07-01 00:00:00

  • The discharge of elderly patients from an accident and emergency department: functional changes and risk of readmission.

    abstract::Four hundred and fifty patients aged 75 years or older were followed up after discharge from an accident and emergency department. Forty-three per cent of all patients experienced some loss of functional independence. A small number, 5.6%, were readmitted to hospital within 14 days. This group were significantly less ...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/19.6.415

    authors: Rowland K,Maitra AK,Richardson DA,Hudson K,Woodhouse KW

    更新日期:1990-11-01 00:00:00

  • Drug compliance amongst psychiatric day hospital attenders.

    abstract::Drug compliance was assessed amongst all 91 patients attending a psychogeriatric day hospital during July 1988. Of the 86 patients taking medication, the 57 functionally and 29 organically ill patients were interviewed at home, the latter with their carers. A disparity in results was shown when compliance was measured...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/19.3.191

    authors: Rosenvinge HP,Groarke EP,Bradshaw JW

    更新日期:1990-05-01 00:00:00

  • A preliminary study of dietary aluminium intake and risk of Alzheimer's disease.

    abstract:BACKGROUND:epidemiological studies of Alzheimer's disease and aluminium intake have focused on aluminium in drinking water. There have been no studies investigating the relation between the disease and the consumption of foods containing large amounts of aluminium additives. OBJECTIVES:to conduct a pilot study to dete...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/28.2.205

    authors: Rogers MA,Simon DG

    更新日期:1999-03-01 00:00:00