Diabetes, hemoglobin A1c, and cognitive performance in older adults: is there any impact of frailty? Evidence from the ELSI-Brazil study.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2024-02-19 eCollection Date: 2024-01-01 DOI:10.1590/1414-431X2023e12939
J G Souza, D S Farias-Itao, M J R Aliberti, T S Alexandre, C Szlejf, C P Ferri, M F Lima-Costa, C K Suemoto
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Abstract

The aim of this study was to evaluate the association between diabetes and cognitive performance in a nationally representative study in Brazil. We also aimed to investigate the interaction between frailty and diabetes on cognitive performance. A cross-sectional analysis of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) baseline data that included adults aged 50 years and older was conducted. Linear regression models were used to study the association between diabetes and cognitive performance. A total of 8,149 participants were included, and a subgroup analysis was performed in 1,768 with hemoglobin A1c data. Diabetes and hemoglobin A1c levels were not associated with cognitive performance. Interaction of hemoglobin A1c levels with frailty status was found on global cognitive z-score (P-value for interaction=0.038). These results suggested an association between higher hemoglobin A1c levels and lower cognitive performance only in non-frail participants. Additionally, undiagnosed diabetes with higher hemoglobin A1c levels was associated with both poor global cognitive (β=-0.36; 95%CI: -0.62; -0.10, P=0.008) and semantic verbal fluency performance (β=-0.47; 95%CI: -0.73; -0.21, P=0.001). In conclusion, higher hemoglobin A1c levels were associated with lower cognitive performance among non-frail participants. Higher hemoglobin A1c levels without a previous diagnosis of diabetes were also related to poor cognitive performance. Future longitudinal analyses of the ELSI-Brazil study will provide further information on the role of frailty in the association of diabetes and glycemic control with cognitive decline.

老年人的糖尿病、血红蛋白 A1c 和认知能力:虚弱是否有影响?来自巴西 ELSI 研究的证据。
本研究旨在通过一项具有全国代表性的巴西研究,评估糖尿病与认知能力之间的关系。我们还旨在研究虚弱与糖尿病对认知能力的交互作用。我们对巴西老龄化纵向研究(ELSI-Brazil)的基线数据进行了横断面分析,其中包括 50 岁及以上的成年人。研究采用线性回归模型来分析糖尿病与认知能力之间的关系。共纳入了 8,149 名参与者,并对 1,768 名有血红蛋白 A1c 数据的参与者进行了亚组分析。糖尿病和血红蛋白 A1c 水平与认知能力无关。血红蛋白 A1c 水平与虚弱状态的交互作用被发现与总体认知 z 评分有关(交互作用的 P 值=0.038)。这些结果表明,只有非虚弱参与者的血红蛋白 A1c 水平越高,认知能力越低。此外,未确诊的糖尿病患者血红蛋白 A1c 水平越高,其整体认知能力(β=-0.36;95%CI:-0.62;-0.10,P=0.008)和语义语言流畅性(β=-0.47;95%CI:-0.73;-0.21,P=0.001)越差。总之,血红蛋白 A1c 水平越高,非体弱者的认知能力越低。既往未确诊糖尿病的血红蛋白 A1c 水平较高也与认知能力较差有关。未来对ELSI-巴西研究的纵向分析将进一步说明虚弱在糖尿病和血糖控制与认知能力下降之间的关系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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