Muscle Weakness Is Associated With Diabetes in Older Mexicans: The Mexican Health and Aging Study

Background: The risk of cardiovascular problems due to diabetes mellitus is highest among older Mexicans, and yet what remains to be determined is the association between muscle weakness and diabetes in this population. Therefore, the purpose of this study was to determine the association between muscle strength and diabetes among Mexican adults greater than 50 years of age. Design: Cross-sectional. Setting: National sample of households in both urban and rural areas. Participants: A subsample of 1841 individuals aged 50 years and older was included from the 2012 Mexican Health and Aging Study. Measurements: Strength was assessed using a hand-held dynamometer, and the single largest reading from either hand was normalized to body mass (normalized grip strength [NGS]). Conditional inference tree analyses were used to identify sex-specific NGS weakness thresholds. Linear regression was used to examine the association between NGS and HbA1c, and logistic regression was used to assess the association between weakness and risk of diabetes (HbA1c >= 6.5% [>= 48 mmol/mol]), after controlling for age, sex, and waist circumference. Results: NGS was inversely associated with HbA1c (beta - -1.56; P<.001). Optimal sex-specific NGS weakness thresholds to detect diabetes were <= 0.46 and <= 0.30 for men and women, respectively. Weakness was associated with significantly increased odds of diabetes (odds ratio, 1.69; 95% confidence interval, 1.37-2.10), even after adjusting for age, sex, and waist circumference. Conclusions: NGS was robustly associated with diabetes and other cardiometabolic risk factors in older Mexicans. This simple screen may serve as a valuable tool to identify adults that are at risk for negative health consequences or early mortality and who might benefit from lifestyle interventions to reduce risk. (C) 2016 AMDA - The Society for Post-Acute and Long-Term Care Medicine.