Quadriceps strength, quadriceps power, and gait speed in older U.S. adults with diabetes mellitus: results from the National Health and Nutrition Examination Survey, 1999–2002
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Objectives: To examine the independent association between diabetes mellitus (and its duration and severity) and quadriceps strength, quadriceps power, and gait speed in a national population of older adults. Design: Cross‐sectional nationally representative survey. Setting: United States. Participants: Two thousand five hundred seventy‐three adults aged 50 and older in the N ational H ealth and N utrition E xamination S urvey 1999–2002 who had assessment of quadriceps strength. Methods: Diabetes mellitus was ascertained according to questionnaire. Measurement of isokinetic knee extensor (quadriceps) strength was performed at 60º/s. Gait speed was assessed using a 20‐foot walk test. Multiple linear regression analyses were used to assess the association between diabetes mellitus status and outcomes, adjusting for potential confounders or mediators. Results: Older U.S. adults with diabetes mellitus had significantly slower gait speed (0.96 ± 0.02 m/s) than those without (1.08 ± 0.01 m/s; P < .001). After adjusting for demographic characteristics, weight, and height, diabetes mellitus was also associated with significantly lower quadriceps strength (−4.6 ± 1.9 Nm; P = .02) and power (−4.9 ± 2.0 W; P = .02) and slower gait speed (−0.05 ± 0.02 m/s; P = .002). Associations remained significant after adjusting for physical activity and C‐reactive protein. After accounting for comorbidities (cardiovascular disease, peripheral neuropathy, amputation, cancer, arthritis, fracture, chronic obstructive pulmonary disease), diabetes mellitus was independently associated only with gait speed (−0.04 ± 0.02 m/s; P = .02). Diabetes mellitus duration in men and women was negatively associated with age‐adjusted quadriceps strength (−5.7 and −3.5 Nm/decade of diabetes mellitus, respectively) and power (−6.1 and −3.8 W/decade of diabetes mellitus, respectively) (all P ≤ .001, no significant interactions according to sex). Glycosylated hemoglobin was not associated with outcomes after accounting for body weight. Conclusion: Older U.S. adults with diabetes mellitus have lower quadriceps strength and quadriceps power that is related to the presence of comorbidities and walk slower than those without diabetes mellitus. Future studies should investigate the relationship between hyperglycemia and subsequent declines in leg muscle function.
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Longer duration of diabetes is associated with proportionally lower quadriceps strength in older adults.
“Longer duration of diabetes is also associated with proportionally lower quadriceps strength in older adults (aged 50 and older).39”
From Age-related and disease-related muscle loss: The effect of diabetes, obesity, and other diseases (2014) · cites this paper as [39]
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- Authors
- Kalyani, R. R., Tra, Y., Yeh, H., Egan, J. M., Ferrucci, L., & Brancati, F. L.
- Affiliations
- Johns Hopkins University (US)
- University of Maryland, Baltimore (US)
- National Institute on Aging (US)
- Corresponding author
- Kalyani, Rita Rastogi
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2013-04-25
- Volume
- 61
- Issue
- 5
- Pages
- 769-775
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- PMC
- PMC3725774
- OpenAlex
- W2078965485
- Cited by
- 147
- References
- 28
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 12 · 2023: 11 · 2022: 12 · 2021: 15 · 2020: 11 · 2019: 11 · 2018: 11 · 2017: 12 · 2016: 12 · 2015: 14 · 2014: 13 · 2013: 1
- FWCI
- 9.26
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5p60dk079637-02)
- National Institute on Aging (P30AG021334)
- National Institute of Diabetes and Digestive and Kidney Diseases (P60 DK-079637, K24DK062222, R24DK084949, P30DK079637, K23DK093583)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- diabetes mellitus, older adults, quadriceps strength, walking speed, diabetes duration, muscle strength, physical function, comorbidities, HbA1c, C-reactive protein, physical activity, sex differences, United States
- MeSH terms
- Aged, Aged, 80 and over, Cross-Sectional Studies, Diabetes Mellitus, Female, Gait, Humans, Male, Middle Aged, Morbidity, Nutrition Surveys, Surveys and Questionnaires, Retrospective Studies, United States, Walking, Quadriceps Muscle, Muscle Strength
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