The Association of Duration of Type 2 Diabetes with Cognitive Performance is Modulated by Long-Term Glycemic Control
The Association of Duration of Type 2 Diabetes with Cognitive Performance is Modulated by Long-Term Glycemic Control
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DOI：
10.1016/j.jagp.2014.01.010
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发表时间：
2014-10-01
影响因子：
7.2
通讯作者：
Schnaider-Beeri, Michal
中科院分区：
文献类型：
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作者：
West, Rebecca K.;Ravona-Springer, Ramit;Schnaider-Beeri, Michal
目的：目前尚不清楚为什么2型糖尿病（T2 D）的持续时间与认知损害增加有关。高血红蛋白A1 c（HbA 1c）也与痴呆相关，是T2 D并发症的主要原因。在这里，我们研究了T2 D持续时间与认知功能的关联是否受HbA 1C水平的调节。研究方法：本研究检查了非痴呆社区居住的T2 D老年人（N = 897）参与以色列糖尿病和认知功能下降研究，他们进行了广泛的神经心理电池评估。受试者均来自Maccabi医疗服务中心，该中心自1998年以来就有糖尿病登记处，并有完整的HbA 1c测量结果。进行偏相关分析，以检查HbA 1c对T2 D持续时间与五项认知指标之间关系的调节作用，控制社会人口统计学和心血管风险因素。结果如下：T2 D持续时间与HbA 1c的相互作用与执行功能相关（p = 0.006），语义分类（p = 0.019），注意力/工作记忆（p = 0.011），总体认知（p = 0.006），这样，随着HbA 1c水平的增加，T2 D持续时间和认知障碍之间的相关性增加，但对于情景记忆则没有（p = 0.984）。结论：由于T2 D的持续时间与较高HbA 1c水平的认知相关，并且在较低HbA 1c水平中总体上没有发现相关性，因此我们的研究结果表明，T2 D患者可以通过保持长期良好的血糖控制来限制其未来认知能力下降的风险。
Objectives: It is unclear why duration of type 2 diabetes (T2D) is associated with increased cognitive compromise. High hemoglobin A1c (HbA1c) has also been associated with dementia, and is the primary contributor to T2D complications. Here we investigated whether the association of duration of T2D with cognitive functioning is modulated by HbA1C levels. Methods: This study examined nondemented community-dwelling T2D elderly (N = 897) participating in the Israel Diabetes and Cognitive Decline study, who were assessed with a broad neuropsychological battery. Subjects were all from the Maccabi Healthcare Services, which has a Diabetes Registry with complete HbA1c measurements since 1998. Partial correlations were performed to examine the modulating effect of HbA1c on the relationship of duration of T2D with five cognitive measures, controlling for sociodemographic and cardiovascular risk factors. Results: An interaction of duration of T2D with HbA1c was associated with executive functioning (p = 0.006), semantic categorization (p = 0.019), attention/working memory (p = 0.011), and overall cognition (p = 0.006), such that the associations between duration of T2D and cognitive impairment increased as HbA1c levels increased-but not for episodic memory (p = 0.984). Conclusions: Because duration of T2D was associated with cognition in higher HbA1c levels and overall no associations were found in lower HbA1c levels, our results suggest that individuals with T2D may limit their risk of future cognitive decline by maintaining long-term good glycemic control.