Division of Population Health Research, Department of Precision Medicine, Korea National Institute of Health, Cheongju-si, Chungcheongbuk-do, Republic of Korea.
Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
Front Public Health. 2024 Nov 11;12:1417236. doi: 10.3389/fpubh.2024.1417236. eCollection 2024.
Cohort studies on the risk of cognitive impairment in the older population of S. Korea based on glycosylated hemoglobin (HbA1c) levels are exceedingly rare. This study aimed to analyze the association between HbA1c levels and cognitive impairment in older Korean adults without dementia.
We conducted a cross-sectional study using data from a community-based Ansan cohort (2009-2010), which was part of the Korea Genome Epidemiology Study. The study included 853 cohort participants aged ≥59 years living in Ansan city. Cognitive function was evaluated using the Korean version of the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). The MMSE and MoCA scores were categorized into normal cognition (≥24 and ≥ 23, respectively) and cognitive impairment (≤23 and ≤ 22, respectively). Multiple logistic regression analysis was used to estimate the association between HbA1c levels and cognitive impairment, with adjustments for covariates.
The mean age of the participants was 66 years, and 433 (50.8%) were female. Cognitive impairment was observed in 12.5 and 44.3% of participants, based on the MMSE and MoCA, respectively. Regarding the MMSE scores, HbA1c level was a risk factor for cognitive impairment in women. Compared to normal HbA1c (≤5.6%) levels, adjusted odds ratios of MMSE decline for HbA1c 5.7-6.4% and HbA1c ≥6.5% were high: 2.16 (95% confidence interval [CI] 1.04-4.49) and 2.96 (95% CI, 1.04-8.39), respectively.
By improving glycemic control, the risk of cognitive impairment in the older population can be reduced. Further research on the role of sex differences in cognitive impairment is needed.
基于糖化血红蛋白（HbA1c）水平，对韩国老年人群认知障碍风险的队列研究极为罕见。本研究旨在分析 HbA1c 水平与无痴呆的韩国老年成年人认知障碍之间的关联。
我们使用来自社区为基础的安山队列（2009-2010 年）的数据进行了一项横断面研究，该队列是韩国基因组流行病学研究的一部分。该研究包括居住在安山市的 853 名≥59 岁的队列参与者。使用韩国版简易精神状态检查（MMSE）和蒙特利尔认知评估（MoCA）评估认知功能。MMSE 和 MoCA 评分分为正常认知（≥24 和≥23）和认知障碍（≤23 和≤22）。采用多因素逻辑回归分析，调整了协变量后，评估了 HbA1c 水平与认知障碍之间的关系。
参与者的平均年龄为 66 岁，433 名（50.8%）为女性。根据 MMSE 和 MoCA，分别有 12.5%和 44.3%的参与者存在认知障碍。就 MMSE 评分而言，HbA1c 水平是女性认知障碍的一个危险因素。与正常的 HbA1c（≤5.6%）水平相比，HbA1c 5.7-6.4%和 HbA1c≥6.5%的 MMSE 下降调整比值比分别为 2.16（95%置信区间 [CI] 1.04-4.49）和 2.96（95% CI，1.04-8.39）。
通过改善血糖控制，可以降低老年人群认知障碍的风险。需要进一步研究性别差异在认知障碍中的作用。
