Associations Between Diabetes and Cognitive Function in Socioeconomically Diverse African American and White Men and Women.
Associations Between Diabetes and Cognitive Function in Socioeconomically Diverse African American and White Men and Women.
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DOI：
10.1097/psy.0000000000000196
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发表时间：
2015-07
影响因子：
3.3
通讯作者：
Zonderman AB
中科院分区：
文献类型：
--
作者：
Dore GA;Waldstein SR;Evans MK;Zonderman AB
在一个双胞胎的城市居民样本中，研究种族和贫困（定义为收入<联邦贫困线的125%）是否改变了糖尿病和认知之间的关联。2066名参与者的横断面数据（平均年龄= 47.6岁，56.8%为女性，56.2%为非洲裔美国人，38.6%低于贫困）来自第一波的健康老龄化社区的多样性跨寿命（HANDLS）研究。11项测试测量了认知功能。多元回归分析评估了糖尿病、种族和贫困状况与认知之间的相互作用。糖尿病、种族和贫困状况之间存在显著的相互作用。在贫困的非裔美国人中，糖尿病患者在以下方面的表现低于非糖尿病患者：加州语言学习测验自由回忆短暂延迟（z=-0.444 ± 0.123 vs. z=-0.137 ± 0.045）和长延迟（z=-0.299 ± 0.123 vs. z=-0.130 ± 0.045），数字跨度向后（z=-0.347 ± 0.109 vs. z=-0.072 ± 0.041），以及注意力简易测试（z=-0.452 ± -0.099 vs z=-0.099 ± 0.047），类别流畅性更高（z=0.114 ± 0.117 vs z=-0.118 ± 0.044）。在贫困线以上的非裔美国人和白色参与者中，糖尿病患者和非糖尿病患者之间没有一致的差异。糖尿病与生活在贫困中的非裔美国人的言语记忆、工作记忆和注意力表现较差有关。糖尿病非裔美国人在贫困以下可能会增加年轻时认知缺陷的风险。改善卫生知识普及、医患沟通和对贫困个人的多学科医疗护理可能会减少差异。需要进一步的研究来澄清这些关联的机制。
To examine whether race and poverty, defined as income <125% of the federal poverty limit, modifies associations between diabetes and cognition in a biracial, urban-dwelling sample. Cross-sectional data for 2066 participants (mean age = 47.6 years, 56.8% women, 56.2% African American, 38.6% below poverty) from the first wave of the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study were used for analyses. Eleven tests measured cognitive function. Interactions among diabetes, race, and poverty status with cognition were assessed in multiple regression analyses. Significant interactions among diabetes, race, and poverty status were observed. Among African Americans below poverty, diabetic individuals performed lower than non-diabetic individuals on: California Verbal Learning Test Free Recall Short Delay (z=-0.444 ± 0.123 vs. z=-0.137 ± 0.045) and Long Delay (z=-0.299 ± 0.123 vs. z=-0.130 ± 0.045), Digit Span Backward (z=-0.347 ± 0.109 vs. z=-0.072 ± 0.041), and the Brief Test of Attention (z=-0.452 ± -0.099 vs z=-0.099 ± 0.047), and higher on Category Fluency (z=0.114 ± 0.117 vs. z=-0.118 ± 0.044). No consistent differences between diabetic and non-diabetic individuals were found for African American and white participants above the poverty level. Diabetes was associated with poorer verbal memory, working memory, and attention performance among African Americans living in poverty. Diabetic African Americans below poverty may have increased risk of cognitive deficit at a younger age. Improving health literacy, doctor-patient communication and multidisciplinary medical care for impoverished individuals may reduce differences. Additional research is needed to clarify the mechanisms underlying these associations.