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Instrumental activity of daily living combined with glycated hemoglobin predict cardiovascular disease

Li Zhao1, Yijun Liu1, Zhen Tan1

  • 1Emergency Intensive Care Unit. Suining Central Hospital. Suining.

Nutricion Hospitalaria
|June 16, 2026
PubMed

Insights

Individuals with both impaired instrumental activities of daily living (IADL) and high glycated hemoglobin (HbA1c) face a significantly higher risk of cardiovascular diseases (CVDs). This highlights the importance of managing both factors for cardiovascular health.

Area of Science:

  • Gerontology
  • Cardiology
  • Endocrinology

Background:

  • Cardiovascular diseases (CVDs) pose a significant health burden, particularly in aging populations.
  • Instrumental activities of daily living (IADL) disability and elevated glycated hemoglobin (HbA1c) are common in older adults.
  • The combined impact of IADL limitations and glycemic control on CVD risk is not fully understood.

Purpose of the Study:

  • To investigate the synergistic association between IADL disability and HbA1c levels with the risk of incident cardiovascular disease events.
  • To quantify the risk of CVDs, heart disease, and stroke in individuals with varying combinations of IADL status and HbA1c levels.

Main Methods:

  • Analysis of data from 7761 participants in the Chinese Health and Retirement Longitudinal Study (CHARLS).
  • Utilized Kaplan-Meier curves and Cox regression models to assess the relationship between IADL, HbA1c, and CVD risk.
  • Employed propensity score matching (PSM) to validate findings and mitigate confounding factors.

Main Results:

  • Over a median follow-up of 109 months, 2013 CVD events were recorded.
  • Individuals with both IADL disability and high HbA1c (Q3) showed a significantly increased risk for CVDs (aHR=1.50), heart disease (aHR=1.41), and stroke (aHR=1.60) compared to those without IADL disability and normal HbA1c (Q1).
  • Propensity score matching confirmed that the Q3 group had a higher risk of CVDs (aHR=1.54), heart disease (aHR=1.47), and stroke (aHR=1.66).

Conclusions:

  • The combination of IADL disability and elevated HbA1c levels is a significant risk factor for cardiovascular diseases.
  • Assessing both functional status and glycemic control is crucial for comprehensive CVD risk stratification in older adults.
  • Interventions targeting both IADL improvement and HbA1c management may be beneficial in reducing CVD risk.
Abstract

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