Wang Lingling, Zhou Qin, Yin Yushuang, Zhang Wenqi, Wang Chen, Lin Guanwen, Wu Duozhi, Wang Zhihua
Department of Anesthesiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China.
Department of Anesthesiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Front Neurosci. 2025 May 6;19:1550077. doi: 10.3389/fnins.2025.1550077. eCollection 2025.
Cognitive impairment poses a considerable challenge to public health systems worldwide, and its severity often varies depending on racial disparities. Diabetes, a prevalent chronic disease, is also known to adversely affect cognitive function. However, the interaction between race and diabetes in influencing cognitive function has not been well defined. This study aims to investigate the combined effects of race and diabetes on cognitive function using a demographically diverse group of elderly individuals.
Data were drawn from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014, involving a sample of 2,586 elderly participants aged 60 and above. Multivariate regression models were employed to assess the effects of race, diabetes status, and their interaction on cognitive test scores. Cognitive function was evaluated using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) test, the Delayed Recall Test, the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST).
Mexican Americans and Non-Hispanic Black people have the most frequent rates of diabetes. Non-Hispanic White people score the highest in all cognitive tests, while Mexican Americans and other Hispanics score the lowest ( < 0.001). Diabetic individuals score significantly lower than non-diabetics across all cognitive tests, with the most pronounced difference observed in DSST scores ( < 0.001). The negative association between diabetes status and DSST scores remained significant after adjusting for confounders ( < 0.001). Notably, the interaction between race and diabetes did not significantly influence cognitive function across the cognitive tests.
This study found significant differences in diabetes prevalence and cognitive performance by race, along with a robust negative correlation between diabetes status and cognitive function. However, the interaction between race and diabetes does not significantly affect cognitive function.
认知障碍对全球公共卫生系统构成了相当大的挑战，其严重程度往往因种族差异而异。糖尿病是一种常见的慢性病，也已知会对认知功能产生不利影响。然而，种族与糖尿病在影响认知功能方面的相互作用尚未得到明确界定。本研究旨在使用一组人口统计学特征多样的老年个体来调查种族和糖尿病对认知功能的综合影响。
数据取自2011年至2014年的美国国家健康与营养检查调查（NHANES），涉及2586名60岁及以上的老年参与者样本。采用多元回归模型来评估种族、糖尿病状态及其相互作用对认知测试分数的影响。使用阿尔茨海默病注册协会（CERAD）测试、延迟回忆测试、动物流畅性测试（AFT）和数字符号替换测试（DSST）来评估认知功能。
墨西哥裔美国人和非西班牙裔黑人的糖尿病发病率最高。非西班牙裔白人在所有认知测试中的得分最高，而墨西哥裔美国人和其他西班牙裔得分最低（<0.001）。在所有认知测试中，糖尿病患者的得分显著低于非糖尿病患者，在DSST分数中观察到的差异最为明显（<0.001）。在调整混杂因素后，糖尿病状态与DSST分数之间的负相关仍然显著（<0.001）。值得注意的是，种族与糖尿病之间的相互作用在所有认知测试中并未显著影响认知功能。
本研究发现不同种族在糖尿病患病率和认知表现方面存在显著差异，同时糖尿病状态与认知功能之间存在强烈的负相关。然而，种族与糖尿病之间的相互作用并未显著影响认知功能。
