Glycated hemoglobin and dynapenia in community- dwelling older people with and without diabetes: A cross-sectional study.

Purpose: Dynapenia, an age-related loss of muscle strength, is associated with adverse outcomes in older people. Elevated glycated hemoglobin (HbA1c) levels may accelerate muscle decline, especially in individuals with diabetes mellitus. This study aimed to determine whether HbA1c levels are associated with dynapenia in community-dwelling older people, and whether this association differs between those with and without diabetes mellitus. Methods: A population-based cross-sectional study was conducted with a probabilistic sample of 404 community-dwelling older people in southern Brazil. Data collection included home interviews, physical assessments, and laboratory tests. Dynapenia was defined as mean handgrip strength below 26 kg for men and 16 kg for women. HbA1c was measured by high-performance liquid chromatography. Multiple logistic regression was used to assess the association between HbA1c and dynapenia, stratified by diabetes status. Results: The sample was predominantly female (72.0%) and aged 60-69 years (44.3%). The prevalence of diabetes mellitus was 36.4%, and dynapenia was observed in 23.5% of participants. In multivariable logistic regression analysis, higher HbA1c levels were independently associated with dynapenia among older people with diabetes mellitus (adjusted odds ratio = 1.34; 95% confidence interval: 1.05-1.71), regardless of sex, age, body mass index, and physical activity. Conclusion: Glycemic control is crucial to prevent muscle strength decline in older people with diabetes mellitus. Monitoring muscle strength should be part of clinical care to reduce functional impairment and adverse outcomes in this population.