Dyer Adam H, Briggs Robert, Laird Eamon, Hoey Leane, Hughes Catherine F, McNulty Helene, Ward Mary, Strain J J, Molloy Anne M, Cunningham Conal, McCarroll Kevin
Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland.
Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland.
Diabet Med. 2021 Nov;38(11):e14668. doi: 10.1111/dme.14668. Epub 2021 Aug 14.
Given that diabetes is associated with cognitive impairment and dementia in later life, we aimed to investigate the relationship between glycated haemoglobin (HbA ), diabetes and domain-specific neuropsychological performance in older adults.
Cross-sectional cohort study using data from the Trinity-Ulster-Department of Agriculture (TUDA) study. Participants underwent detailed cognitive and neuropsychological assessment using the Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB) and Repeatable Assessment for Neuropsychological Status (RBANS). Linear regression was used to assess associations between HbA , diabetes status and neuropsychological performance, with adjustment for important clinical covariates.
Of 4938 older adults (74.1 ± 8.3 years; 66.9% female), 16.3% (n = 803) had diabetes (HbA ≥ 6.5%; 48 mmol/mol), with prediabetes (HbA ≥ 5.7%-6.4%; 39-47 mmol/mol) present in 28.3% (n = 1395). Increasing HbA concentration was associated with poorer overall performance on the FAB [β: -0.01 (-0.02, -0.00); p = 0.04 per % increase] and RBANS [β = -0.66 (-1.19, -0.13); p = 0.02 per % increase]. Increasing HbA was also associated with poorer performance on immediate memory, visuo-spatial, language and attention RBANS domains. Diabetes was associated poorer performance on neuropsychological tests of immediate memory, language, visual-spatial and attention.
Both increasing HbA and the presence of diabetes were associated with poorer cognitive and domain-specific performance in older adults. HbA , and not just diabetes status per se, may represent an important target in the promotion of optimal brain health in older adults.
鉴于糖尿病与晚年认知障碍和痴呆症相关，我们旨在研究老年人糖化血红蛋白（HbA）、糖尿病与特定领域神经心理表现之间的关系。
采用来自三一学院-阿尔斯特大学-农业系（TUDA）研究的数据进行横断面队列研究。参与者使用简易精神状态检查表（MMSE）、额叶评估量表（FAB）和神经心理状态可重复性评估量表（RBANS）接受了详细的认知和神经心理评估。使用线性回归评估HbA、糖尿病状态与神经心理表现之间的关联，并对重要的临床协变量进行校正。
在4938名老年人（74.1±8.3岁；66.9%为女性）中，16.3%（n = 803）患有糖尿病（HbA≥6.5%；48 mmol/mol），28.3%（n = 1395）存在糖尿病前期（HbA≥5.7%-6.4%；39-47 mmol/mol）。HbA浓度升高与FAB上较差的总体表现[β：-0.01（-0.02，-0.00）；每增加1%，p = 0.04]和RBANS上较差的总体表现[β = -0.66（-1.19，-0.13）；每增加1%，p = 0.02]相关。HbA升高还与即刻记忆、视觉空间、语言和注意力RBANS领域的较差表现相关。糖尿病与即刻记忆、语言、视觉空间和注意力的神经心理测试中较差的表现相关。
HbA升高和糖尿病的存在均与老年人较差的认知和特定领域表现相关。HbA，而不仅仅是糖尿病状态本身，可能是促进老年人最佳脑健康的一个重要靶点。
