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

BACKGROUND: we aimed to assess the combined association of instrumental activity of daily living (IADL) and glycated hemoglobin (HbA1c) with the risk of cardiovascular disease events (CVDs). METHODS: this study involved 7761 individuals from CHARLS. Kaplan-Meier curves and cox regression models were conducted to evaluate the relationship of different subgroups with CVDs. Propensity score matching (PSM) was conducted to validate our results. RESULTS: during a median follow-up period of 109 months, a total of 2013 cases of CVDs (1566 heart disease and 667 stroke) were observed. Cox regression models analysis revealed that individuals in Q2 (HbA1c < median with IADL disability or HbA1c ≥ median without IADL disability) and Q3 (HbA1c ≥ median with IADL disability) were significantly associated with an increased risk of CVDs compared to those in Q1 (HbA1c < median without IADL disability) (Q2 vs. Q1: adjusted HR = 1.16 (1.05-1.28) for CVDs, adjusted HR = 1.14 (1.02-1.28) for heart disease; Q3 vs. Q1: adjusted HR = 1.50 (1.29-1.70) for CVDs, adjusted HR = 1.41 (1.18-1.67) for heart disease, and adjusted HR = 1.60 (1.24-2.06) for stroke). RCS curves demonstrated a significant and linear relationship between HbA1c levels and CVDs. Furthermore, PSM analysis also demonstrated that individuals in Q3 had a higher risk of CVDs, heart disease, and stroke compared to those in Q1 (adjusted HR = 1.54 (1.27-1.87) for CVDs, adjusted HR = 1.47 (1.18-1.83) for heart disease, and adjusted HR = 1.66 (1.21-2.29) for stroke). CONCLUSION: the combination of IADL disability and HbA1c level is associated with an increased risk of CVDs.