Associations between diabetes status and grip strength trajectory sub-groups in adulthood: findings from over 16 years of follow-up in the MRC National Survey of Health and Development

Background: Cross-sectional studies suggest a relationship between diabetes status and weaker grip strength (GS) in adulthood and limited evidence from longitudinal studies has focussed on the association with average change in GS. We aimed to investigate whether diabetes status was related to membership of distinct GS trajectories in mid-to-late adulthood in 2,263 participants in the Medical Research Council National Survey of Health and Development.

Methods: Grip strength (kg) was measured at 53, 60-64 and 69 years. Pre-/diabetes was defined at 53 years based on HbA1c>5.6% and/or doctor-diagnosis of diabetes. Sex-specific latent class trajectory models were developed and multinomial logistic regression was used to investigate the association between pre-/diabetes status and membership into GS trajectory classes.

Results: For both males and females, a 3-class solution (‘High’, ‘Intermediate’, ‘Low’) provided the best representation of the GS data and the most plausible solution. There was no evidence that pre-/diabetes status was associated with class membership in either sex: e.g., adjusted odds ratios of being in the ‘Low’ class (vs ‘High’) for males with pre-/diabetes (vs no-diabetes) was 1.07 (95% CI:0.45,2.55).

Conclusion: Using a flexible data-driven approach to identify GS trajectories between 53-69 years, we observed three distinct GS trajectories, all declining, in both sexes. There was no association between pre-/diabetes status at 53 years and membership into these GS trajectories. Understanding the diabetes status―GS trajectories association is vital to ascertain the consequences that projected increases in pre-/diabetes prevalence’s are likely to have.