School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Bia-Echo Asia Centre for Reproductive Longevity & Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
J Alzheimers Dis. 2023;93(4):1509-1520. doi: 10.3233/JAD-220822.
The Cognitive role of untreated type 2 diabetes mellitus (T2DM) has been less well substantiated.
We sought to explore the prospective association of T2DM and untreated T2DM with cognitive function among middle-aged and older Chinese adults.
Data of 7,230 participants without baseline brain damage/mental retardation, or memory-related diseases in China Health and Retirement Longitudinal Study (CHARLS) from 2011- 2012 to 2015, were analyzed. Fasting plasma glucose and self-reported information on T2DM diagnosis and treatment were assessed. Participants were categorized into normoglycemia, impaired fasting glucose (IFG), and T2DM (including untreated and treated T2DM) groups. Episodic memory and executive function were assessed by modified Telephone Interview for Cognitive Status every two years. We used generalized estimating equation model to examine the association of baseline T2DM status with cognitive function in succeedingyears.
Compared to those with normoglycemia, T2DM was associated with worse overall cognitive function after controlling for demographic variables, lifestyles, follow-up time, major clinical factors, and baseline cognitive function, although the associations were statistically non-significant (β= -0.19, 95% CI: -0.39, 0.00). However, a significant association was mainly observed for those with untreated T2DM (β= -0.26, 95% CI: -0.47, -0.04), especially in the domain of executive function (β= -0.19, 95% CI: -0.35, -0.03). In general, IFG and treated T2DM individuals had similar levels of cognitive function with normoglycemia participants.
Our findings supported a detrimental role of untreated T2DM on cognitive function among middle-aged and older adults. Screening and early treatment for T2DM are warranted for maintaining better cognitive function in later life.
未经治疗的 2 型糖尿病（T2DM）的认知作用尚未得到充分证实。
我们旨在探讨中年和老年中国成年人中未经治疗的 T2DM 与认知功能之间的前瞻性关联。
分析了中国健康与退休纵向研究（CHARLS）中 2011-2012 年至 2015 年期间无基线脑损伤/智力低下或记忆相关疾病的 7230 名参与者的数据。评估了空腹血糖和自我报告的 T2DM 诊断和治疗信息。参与者分为正常血糖、空腹血糖受损（IFG）和 T2DM（包括未经治疗和治疗的 T2DM）组。每两年通过改良电话访谈认知状态评估情景记忆和执行功能。我们使用广义估计方程模型来检验基线 T2DM 状态与随后几年认知功能的关系。
与正常血糖组相比，在控制人口统计学变量、生活方式、随访时间、主要临床因素和基线认知功能后，T2DM 与认知功能总体下降相关，但关联无统计学意义（β=-0.19，95%CI：-0.39，0.00）。然而，未经治疗的 T2DM 患者的关联更为显著（β=-0.26，95%CI：-0.47，-0.04），尤其是在执行功能领域（β=-0.19，95%CI：-0.35，-0.03）。总的来说，IFG 和治疗的 T2DM 个体与正常血糖参与者的认知功能水平相似。
我们的研究结果支持未经治疗的 T2DM 对中年和老年人群认知功能的有害作用。筛查和早期治疗 T2DM 对于维持晚年更好的认知功能是必要的。
