scholarly journals Association Between Baseline Glycemic Markers (HbA1c) and 8-Year Trajectories of Functional Disability

2019 ◽  
Vol 74 (11) ◽  
pp. 1828-1834 ◽  
Author(s):  
Miriam Mutambudzi ◽  
Carlos Díaz-Venegas ◽  
Sonia Menon
Keyword(s):  
Glycemic Control ◽  
Latent Class ◽  
Functional Disability ◽  
Multinomial Logistic Regression ◽  
Clinical Care ◽  
Multinomial Logistic Regression Analysis ◽  
Glycemic Markers ◽  
Risk Ratios ◽  
Retirement Study ◽  
Hba1c Levels

Abstract Background This study assessed whether baseline (i) HbA1c (low [<5.7%], intermediate [5.7%–6.4%], and high [≥6.5%]) and (ii) glycemic control (7% HbA1c cutoff) in participants with self-reported diabetes were associated with differential 8-year functional disability trajectories. Methods We used data from the 2006–2014 waves of the Health and Retirement Study for adults aged 50 years and older. Latent class mixture modeling was used to identify distinct functional disability trajectory classes. Multinomial logistic regression analysis examined the association between the newly constructed trajectories and baseline HbA1c levels, and glycemic control, respectively. Results All participants (N = 5,966) were classified into four functional disability trajectory classes (no disability, low disability, low-increasing, and high-increasing). Participants with elevated HbA1c were at greater risk of being classified into the high-increasing (relative risk ratios = 1.63, 95% confidence interval [CI] = 1.25–2.11) trajectory class. Results showed significant effect modification by age and race. Three functional disability trajectories (no disability, low-increasing, and high-increasing) were identified for participants with self-reported diabetes (n = 1,119). There was no significant association between glycemic control in adults with self-reported diabetes and functional disability trajectory classes. Conclusions Participants with intermediate HbA1c and elevated HbA1c were more likely to be classified into the trajectories with progressing disability over the study period. More research is needed to better understand the association between glycemic markers and functional disability trajectories. Such research may provide insights into improvements for clinical care, self-management, and public health interventions for both conditions.

scholarly journals Correlates of Single Versus Multiple Functional Disabilities Among Aging Americans: Race/Ethnicity and Region of Birth

2020 ◽  
Vol 6 ◽  
pp. 233372142091478
Author(s):  
Ami R. Moore ◽  
Maggie Bohm-Jordan ◽  
Foster Amey ◽  
Elias Mpofu
Keyword(s):  
Functional Disability ◽  
Multinomial Logistic Regression ◽  
Ethnic Disparities ◽  
Multiple Disabilities ◽  
The United States ◽  
Citizenship Status ◽  
Multinomial Logistic Regression Analysis ◽  
Interaction Terms ◽  
Veteran Status ◽  
Race Ethnicity

Background: Significant racial/ethnic disparities exist in the prevalence of functional disability among older Americans. Objective: The study analyzed the odds of older people in the United States experiencing single and multiple disabilities, by race and region of birth. Method: Data came from the American Community Survey (2011–2015). Multinomial logistic regression analysis was used. Results: Region of birth, race/ethnicity, age, citizenship status, duration of stay, sex, marital status, veteran status, educational attainment, poverty status, and class of workers were all significantly associated with reports of either single or multiple disabilities. However, the introduction of the interaction terms for citizenship status by race modified some of the significant results. For instance, being born in Latin America no longer reduced the odds in reports of both single and multiple disabilities. However, compared with Whites and native-born of all races, both Hispanics who were either naturalized or were noncitizens had lower odds of reporting multiple disabilities (27% and 28% lower, respectively), whereas naturalized Hispanics also had significantly reduced odds (22%) for a single disability. Conclusion: These findings add to the disability, race/ethnicity, and place of birth literature.

scholarly journals Glycemic and lipidic profile in diabetic patients undergoing dialysis

2010 ◽  
Vol 54 (9) ◽  
pp. 793-800 ◽  
Author(s):  
Paulo Cezar Fortes ◽  
Jamille Godoy Mendes ◽  
Karoline Sesiuk ◽  
Letícia Barros Marcondes ◽  
Carlos Alberto Mayora Aita ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Glycemic Control ◽  
Clinical Care ◽  
Demographic Data ◽  
Diabetic Patients ◽  
Second Phase ◽  
Glucose Content ◽  
Positive Correlation ◽  
Fasting Glycemia ◽  
Glycemic Markers

OBJECTIVE: The aim of this study is to assess the clinical care pattern and to compare the lipid and glycemic profile in a group of diabetic patients undergoing both hemodialysis (HD) and peritoneal dialysis (PD) and to correlate these data using biomarkers of cardiovascular risk. SUBJECTS AND METHODS: The first phase consisted in performing a survey on demographic data, questions about the medical team and glycemic control. In the second phase, patients were assessed through laboratorial data on their glycemic and lipid profile at a single center for HD and PD. RESULTS: 91 patients was the total population; 70 patients (77%) answered the survey; 66 patients (94%) considered the nephrologist the physician responsible for caring for their glycemic control. Second phase: 59 patients were assessed, 29 undergoing HD and 30 undergoing PD. Fifty-seven percent of the patients had HbA1c above 7%; the level of glycemic markers in patients undergoing peritoneal dialysis was significantly higher than in patients undergoing hemodialysis: HbA1c (9.37 ± 0.5) vs. (7.37 ± 0.49) p < 0.01; fasting glycemia (170 ± 15) vs. (126 ± 15) mg/dL p < 0.05. We found a positive correlation between HbA1c and hyperfibrinogenemia (r = 0.4437, p < 0.0005). CONCLUSIONS: The data reveal that glycemic control in diabetic patients undergoing renal replacement therapy (RRT) is neglected. Peritoneal dialysis is related to the worst level of glycemic markers, possibly due to the glucose content in the dialysis solution, and higher levels from HbA1c have a positive correlation with hyperfibrinogenesis in this population.

scholarly journals Testing frailty, accessible housing, and changes in living arrangements using the Health and Retirement Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 622-622
Author(s):  
Bonnie Albright
Keyword(s):  
Living Arrangements ◽  
Latent Class ◽  
Multinomial Logistic Regression ◽  
Community Dwelling ◽  
Health And Retirement Study ◽  
Physical Frailty ◽  
Frailty Phenotype ◽  
Community Dwelling Older Adults ◽  
The Relationship ◽  
Retirement Study

Abstract This study examined housing accessibility elements of community-dwelling older adults using the Health and Retirement Study (HRS). Housing accessibility elements were tested as moderators in the relationship between prior frailty and later living arrangements. HRS physical measures were used to construct the Physical Frailty Phenotype and the Continuous Frailty Scale. The analytic method for the study was multinomial logistic regression. Latent class analysis was also used to identify housing accessibility element use-types. Study findings will be presented. Strengths and weaknesses of using the HRS to measure home accessibility and construct frailty scales will also be discussed.

scholarly journals Trajectories of Aging Among U.S. Older Adults: Mixed Evidence for a Hispanic Paradox

2018 ◽  
Vol 75 (3) ◽  
pp. 601-612 ◽  
Author(s):  
Wassim Tarraf ◽  
Gail A Jensen ◽  
Heather E Dillaway ◽  
Priscilla M Vásquez ◽  
Hector M González
Keyword(s):  
Latent Class ◽  
Population Heterogeneity ◽  
High Morbidity ◽  
Hispanic Paradox ◽  
Logit Models ◽  
Foreign Born ◽  
Multinomial Logit Models ◽  
Curve Modeling ◽  
Risk Ratios ◽  
Retirement Study

Abstract Objectives A well-documented paradox is that Hispanics tend to live longer than non-Hispanic Whites (NHW), despite structural disadvantages. We evaluate whether the “Hispanic paradox” extends to more comprehensive longitudinal aging classifications and examine how lifecourse factors relate to these groupings. Methods We used biennial data (1998–2014) on adults aged 65 years and older at baseline from the Health and Retirement Study. We use joint latent class discrete time and growth curve modeling to identify trajectories of aging, and multinomial logit models to determine whether U.S.-born (USB-H) and Foreign-born (FB-H) Hispanics experience healthier styles of aging than non-Hispanic Whites (NHW), and test how lifecycle factors influence this relationship. Results We identify four trajectory classes including, “cognitive unhealthy,” “high morbidity,” “nonaccelerated”, and “healthy.” Compared to NHWs, both USB-H and FB-H have higher relative risk ratios (RRR) of “cognitive unhealthy” and “high morbidity” classifications, relative to “nonaccelerated.” These patterns persist upon controlling for lifecourse factors. Both Hispanic groups, however, also have higher RRRs for “healthy” classification (vs “nonaccelerated”) upon adjusting for adult achievements and health behaviors. Discussion Controlling for lifefcourse factors USB-H and FB-H have equal or higher likelihood for “high morbidity” and “cognitive unhealthy” classifications, respectively, relative to NHWs. Yet, both groups are equally likely of being in the “healthy” group compared to NHWs. These segregations into healthy and unhealthy groups require more research and could contribute to explaining the paradoxical patterns produced when population heterogeneity is not taken into account.

Patterns and Predictors of Taiwanese Adult Children’s Intergenerational Exchanges Before and After Economic Stagnation

2021 ◽  
pp. 0192513X2110419
Author(s):  
Fang-Hua Jhang
Keyword(s):  
Latent Class ◽  
Multinomial Logistic Regression ◽  
Geographic Distance ◽  
Multinomial Logistic Regression Analysis ◽  
Intergenerational Exchange ◽  
Economic Stagnation ◽  
Before And After ◽  
Intergenerational Exchanges ◽  
Stagnation Period ◽  
Exchange Patterns

This study explores whether cultural norms and economic performance shape the differences in the patterns of intergenerational exchanges, and analyzes whether structural, normative, or emotional dimensions of intergenerational solidarity predict the derived typology of intergenerational exchange in Taiwan before and after economic stagnation. Data derives from nationally representative samples of adult children with at least one parent alive in 2006 and 2016. Latent class analysis (LCA), measurement invariance with LCA, and multinomial logistic regression analysis are applied to analyze data. The results demonstrate how filial norms and economic stagnation influence the intergenerational exchange patterns. The study identifies five classes of intergenerational exchanges. There was a higher proportion of the high-exchange membership in the period of salary growth, while there was a higher proportion of the memberships of emotion-oriented exchanges during the wage stagnation period. Results reveal that geographic distance exerts a stronger and more consistent association with various exchange patterns.

scholarly journals Metformin Pharmacogenetics: Effects of SLC22A1, SLC22A2, and SLC22A3 Polymorphisms on Glycemic Control and HbA1c Levels

2019 ◽  
Vol 9 (1) ◽  
pp. 17 ◽  
Author(s):  
Laith AL-Eitan ◽  
Basima Almomani ◽  
Ahmad Nassar ◽  
Barakat Elsaqa ◽  
Nesreen Saadeh
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Multinomial Logistic Regression ◽  
Incidence Rates ◽  
P Value ◽  
Nucleotide Polymorphisms ◽  
Hba1c Levels

Type 2 diabetes mellitus (T2DM) constitutes a major portion of Jordan’s disease burden, and incidence rates are rising at a rapid rate. Due to variability in the drug’s response between ethnic groups, it is imperative that the pharmacogenetics of metformin be investigated in the Jordanian population. The objective of this study was to investigate the relationship between twenty-one single nucleotide polymorphisms (SNPs) in the SLC22A1, SLC22A2, and SLC22A3 genes and their effects on metformin pharmacogenetics in Jordanian patients diagnosed with type 2 diabetes mellitus. Blood samples were collected from 212 Jordanian diabetics who fulfilled the inclusion criteria, which were then used in SNP genotyping and determination of HbA1c levels. The rs12194182 SNP in the SLC22A3 gene was found to have a significant association (p < 0.05) with lower mean HbA1c levels, and this association more pronounced in patients with the CC genotype (i.e., p-value was significant before correcting for multiple testing). Moreover, the multinomial logistic regression analysis showed that SNP genotypes within the SLC22A1, SLC22A2, and SLC22A3 genes, body mass index (BMI) and age of diagnosis were significantly associated with glycemic control (p < 0.05). The results of this study can be used to predict response to metformin and other classes of T2DM drugs, making treatment more individualized and resulting in better clinical outcomes.

scholarly journals Who is involved in cyberbullying? Latent class analysis of cyberbullying roles and their associations with aggression, self-esteem, and empathy

2018 ◽  
Vol 12 (4) ◽  
Author(s):  
Anja Schultze-Krumbholz ◽  
Markus Hess ◽  
Jan Pfetsch ◽  
Herbert Scheithauer
Keyword(s):  
Latent Class Analysis ◽  
Latent Class ◽  
Multinomial Logistic Regression ◽  
Self Esteem ◽  
Helping Behavior ◽  
Class Analysis ◽  
Regression Analyses ◽  
Social Competencies ◽  
Multinomial Logistic Regression Analysis ◽  
Post Hoc

The present analyses empirically explored the roles in cyberbullying by using Latent Class Analysis. Potential predictors of class membership were also examined using multinomial logistic regression analysis. Participants were 849 German students (52.7% girls, 45.6% boys, Mage = 13.4 years, SDage = 1.1 years). Observed indicators of latent class measured own involvement in cyberbullying, reactions to cyberbullying of classmates, and behavioral willingness as assistant and as defender. Indicators for the post-hoc regression analyses were proactive aggression, reactive aggression, self-esteem, cognitive, and affective empathy. Control variables were age and gender. A model with five classes was chosen. The classes were labeled prosocial defenders, communicating outsiders, aggressive defenders, bully-victims, and assistants. The results of the post-hoc regression analyses showed that students in the classes especially differed regarding types of aggression and social competencies. Based on answer patterns, cyberbullying roles beyond the bullying-triad can be found. Remarkably, three of the classes are bystanders, i.e. they are not directly involved in cyberbullying. Two of these classes showed helping behavior and made up almost two thirds of the sample. Knowledge about cyberbullying roles and their predictors is important to inform the planning and development of interventions. The results further indicate that interventions should especially take into account antisocial and passive behavioral patterns in the context of cyberbullying.

Comparison of Risk Factors of Falling for Psychiatric Inpatients and General Ward Inpatients Who Had Fallen

2021 ◽  
pp. 107839032110330
Author(s):  
Wen P. Chang ◽  
Hsiu J. Jen
Keyword(s):  
Risk Factors ◽  
Multinomial Logistic Regression ◽  
Psychiatric Patients ◽  
Length Of Hospital Stay ◽  
Psychiatric Inpatients ◽  
General Ward ◽  
Prevention Measures ◽  
Risk Of Falling ◽  
Multinomial Logistic Regression Analysis ◽  
Risk Factors For Falling

BACKGROUND: For psychiatric patients, the issue of falling is complex. OBJECTIVE: The objective of this study was to compare the risk factors for falling in psychiatric inpatients and general ward inpatients who had fallen. METHODS: The researchers first derived official fall records for 122 psychiatric inpatients and then selected 122 psychiatric inpatients who had not fallen as well as 122 general ward patients who had fallen, matched for gender, age, and length of hospital stay at the time of the fall incident. RESULTS: After controlling other variables, multinomial logistic regression analysis revealed that psychiatric inpatients who had fallen and had dizziness (odds ratio [OR] = 7.11, p < .001), had an unsteady gait (OR = 1.97, p = .030), or were not using aids (OR = 0.42, p = .042) were at greater risk of falling than those who had not fallen. The researchers also found that general ward inpatients who had fallen and had higher Charlson Comorbidity Index scores (OR = 1.77, p < .001), were clear-headed (OR = 27.15, p = .001), had dizziness (OR = 11.55, p < .001), were unable to walk (OR = 64.28, p < .001), or were using aids (OR = 3.86, p = .001) were at greater risk of falling than those who had not fallen before. CONCLUSIONS: The causes of falling among psychiatric inpatients and general ward inpatients are different. Medical personnel should understand the medications and attributes of patients for an accurate assessment of their risk factors for falling and thus implement fall prevention measures and health education to reduce falls.

scholarly journals Impact of type 2 diabetes and microvascular complications on mortality and cardiovascular outcomes in a multiethnic Asian population

2021 ◽  
Vol 9 (1) ◽  
pp. e001413
Author(s):  
Jonathan Yap ◽  
Kamalesh Anbalakan ◽  
Wan Ting Tay ◽  
Daniel Ting ◽  
Carol Yim Cheung ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Glycemic Control ◽  
Microvascular Complications ◽  
Population Based ◽  
Cardiovascular Outcomes ◽  
Microvascular Complication ◽  
The Impact ◽  
Hba1c Levels

IntroductionDiabetes mellitus is a growing public health epidemic in Asia. We examined the impact of type 2 diabetes, glycemic control and microvascular complications on mortality and cardiovascular outcomes in a multiethnic population-based cohort of Asians without prior cardiovascular disease.Research design and methodsThis was a prospective population-based cohort study in Singapore comprising participants from the three major Asian ethnic groups: Chinese, Malays and Indians, with baseline examination in 2004–2011. Participants with type 1 diabetes and those with cardiovascular disease at baseline were excluded. Type 2 diabetes, Hemoglobin A1c (HbA1c) levels and presence of microvascular complications (diabetic retinopathy and nephropathy) were defined at baseline. The primary outcome was all-cause mortality and major adverse cardiovascular events (MACEs), defined as a composite of cardiovascular mortality, myocardial infarction, stroke and revascularization, collected using a national registry.ResultsA total of 8541 subjects were included, of which 1890 had type 2 diabetes at baseline. Subjects were followed for a median of 6.4 (IQR 4.8–8.8) years. Diabetes was a significant predictor of mortality (adjusted HR 1.74, 95% CI 1.45 to 2.08, p<0.001) and MACE (adjusted HR 1.64, 95% CI 1.39 to 1.93, p<0.001). In those with diabetes, higher HbA1c levels were associated with increased MACE rates (adjusted HR (per 1% increase) 1.18, 95% CI 1.11 to 1.26, p<0.001) but not mortality (p=0.115). Subjects with two microvascular complications had significantly higher mortality and MACE compared with those with only either microvascular complication (adjusted p<0.05) and no microvascular complication (adjusted p<0.05).ConclusionDiabetes is a significant predictor of mortality and cardiovascular morbidity in Asian patients without prior cardiovascular disease. Among patients with type 2 diabetes, poorer glycemic control was associated with increased MACE but not mortality rates. Greater burden of microvascular complications identified a subset of patients with poorer outcomes.

Sign in / Sign up

Export Citation Format

Share Document