The Association of Late-Life Diabetes Status and Hyperglycemia With Incident Mild Cognitive Impairment and Dementia: The ARIC Study
The Association of Late-Life Diabetes Status and Hyperglycemia With Incident Mild Cognitive Impairment and Dementia: The ARIC Study
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DOI：
10.2337/dc19-0120
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发表时间：
2019-07-01
期刊：
影响因子：
16.2
通讯作者：
Selvin, Elizabeth
中科院分区：
文献类型：
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作者：
Rawlings, Andreea M.;Sharrett, A. Richey;Selvin, Elizabeth
目的研究老年人中糖尿病、血糖控制、糖尿病病程和高血糖生物标志物与轻度认知损害(MCI)和痴呆的关系。研究设计和方法我们对参加第五次(2011-2013)考试的5,099名社区动脉粥样硬化风险(ARIC)研究参与者进行了前瞻性分析。在通过电话、死亡证明代码、监测和随访检查(2016-2017)进行随访期间评估认知状态。在指数检查中，我们将事件认知障碍定义为事件MCI或无痴呆者的事件痴呆；我们还分别检查了每种结果。糖尿病的定义是使用自我报告、药物或HBA(1c)>；=6.5%；糖尿病患者血糖控制差的定义为HbA(1c)>；=7%。我们检测了下列高血糖的生物标志物：糖化血红蛋白(1c)、果糖胺、糖化白蛋白和1，5-脱水葡萄糖醇。结果基线时的平均年龄为76岁，59%为女性，21%为黑人。糖尿病(危险比[HR]1.14[95%CI 1.00，1.31])，糖尿病患者血糖控制差(HR 1.31[95%CI 1.05，1.63])，以及较长的糖尿病病程(>；=5 vs.
OBJECTIVE We sought to examine associations in older adults among diabetes, glycemic control, diabetes duration, and biomarkers of hyperglycemia with incident mild cognitive impairment (MCI) and incident dementia. RESEARCH DESIGN AND METHODS We conducted a prospective analysis of 5,099 participants from the Atherosclerosis Risk in Communities (ARIC) Study who attended the fifth (2011-2013) exam. Cognitive status was assessed during follow-up via telephone calls, death certificate codes, surveillance, and a follow-up examination (2016-2017). We defined incident cognitive impairment as incident MCI or incident dementia in persons dementia-free at the index examination; we also examined each outcome separately. Diabetes was defined using self-report, medications, or HbA(1c) >= 6.5%; poor glycemic control in persons with diabetes was defined as HbA(1c) >= 7%. We examined the following biomarkers of hyperglycemia: HbA(1c), fructosamine, glycated albumin, and 1,5-anhydroglucitol. RESULTS Mean age at baseline was 76 years, 59% were female, and 21% were black. Diabetes (hazard ratio [HR] 1.14 [95% CI 1.00, 1.31]), poor glycemic control in persons with diabetes (HR 1.31 [95% CI 1.05, 1.63]), and longer diabetes duration (>= 5 vs.