Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, UK.
J Psychosom Res. 2013 Sep;75(3):275-8. doi: 10.1016/j.jpsychores.2013.06.032. Epub 2013 Jul 13.
There is a widespread consensus that diabetes impairs cognitive functioning. However, some recent findings have shown that many health conditions generally thought to be detrimental to cognitive functioning are in fact linked to pre-morbid cognitive ability, suggesting reverse causation. To better understand the causality in diabetes-cognition relationship, this study investigates the association of older-age diabetes with concurrent and childhood cognitive functioning.
Lothian Birth Cohort 1936 participants (N=1017) completed the same general cognitive ability test at ages 11 and 70 years. Scores were compared between those with and without diabetes at age 70. Diabetes status was based on self-reports and haemoglobin A1c levels.
People with diabetes had lower mean cognitive ability scores at ages 11 and 70 when compared with those without diabetes. The effect size was roughly similar at both ages (Cohen's d≈0.32). When adjusted for age-11 cognitive ability, diabetes status was not associated with cognitive ability at age 70. The association between childhood cognitive ability and older-age diabetes was partly accounted for by body mass index and cholesterol level in older-age.
In this sample, diabetes was associated with poorer cognitive ability in old age but this was because of life-long lower cognitive ability in people with diabetes instead of diabetes impairing cognitive functioning.
人们普遍认为糖尿病会损害认知功能。然而,一些最近的发现表明,许多通常被认为对认知功能有害的健康状况实际上与发病前的认知能力有关,这表明存在反向因果关系。为了更好地理解糖尿病与认知功能之间的因果关系,本研究调查了老年糖尿病与同时期和儿童期认知功能的关系。
洛锡安出生队列 1936 年的参与者(N=1017)在 11 岁和 70 岁时完成了相同的一般认知能力测试。比较了 70 岁时患有和不患有糖尿病的参与者的得分。糖尿病的状况是基于自我报告和血红蛋白 A1c 水平确定的。
与无糖尿病的参与者相比,患有糖尿病的人在 11 岁和 70 岁时的平均认知能力得分较低。两个年龄段的效应大小大致相似(Cohen's d≈0.32)。在调整了 11 岁时的认知能力后,糖尿病的状况与 70 岁时的认知能力无关。儿童期认知能力与老年糖尿病之间的关联部分可以通过老年时的体重指数和胆固醇水平来解释。
在本样本中,糖尿病与老年时较差的认知能力有关,但这是由于糖尿病患者终生认知能力较低,而不是糖尿病损害认知功能所致。