Abstract P339: Glycemic Excursions and Cognitive Function in Older Adults With Diabetes

Introduction: The association between glucose excursions and cognitive function in older adults with diabetes is not well described. 1,5-anhydroglucitol (1,5-AG) is a novel biomarker of hyperglycemic excursions. Low 1,5-AG levels reflect blood glucose concentrations exceeding the renal filtration threshold (~180 mg/dl) over the prior 1-2 weeks. Our aim was to test the hypothesis that glucose excursions, as measured by 1,5-AG, were associated with lower cognitive function in older adults with diabetes. Methods: We conducted a cross-sectional analysis of 2000 participants with diabetes from ARIC visit 5 (2011-2013). Diabetes was defined based on self-reported physician diagnosis, diabetes medication use, or HbA1c ≥6.5%. Eleven neuropsychological tests were summarized using Z scores and were grouped into three cognitive domains representing memory, executive function, and language; a global measure of cognitive function was also calculated by averaging and standardizing scores from all tests. 1,5-AG was dichotomized at 10 μg/mL, with values <10 μg/mL reflecting glycemic excursions. Participants were categorized into one of four groups based on 1,5-AG categories and glycemic control (HbA1c <7% vs ≥7%). We used linear regression and adjusted for demographic and clinical characteristics. Results: The mean age of participants was 75 years, 57% were female, and 78% were white. For persons with HbA1c ≥7%, the adjusted differences in cognitive scores comparing 1,5-AG <10 to 1,5-AG ≥10 ug/mL were significantly lower in all domains except memory (Figure). For persons with HbA1c <7%, there were no significant differences in cognitive scores between 1,5-AG categories. Conclusions: Short-term glucose excursions are independently associated with lower cognitive scores in older adults with diabetes and with poor glycemic control (HbA1c ≥7%). Prospective studies are needed to determine if targeting hyperglycemic excursions can improve cognitive function in older adults with diabetes.

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COGNITION OLDER ADULTS WITH PREDIABETES EXPERIENCE ACCELERATED NEUROCOGNITIVE DECLINE

Innovation in Aging ◽

10.1093/geroni/igz038.2427 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S654-S655

Author(s):

Joyla Furlano ◽

Lindsay Nagamatsu

Keyword(s):

Older Adults ◽

Hippocampal Volume ◽

Brain Health ◽

Cross Sectional ◽

Cognitive Domains ◽

Functional Brain ◽

Cross Sectional Analysis ◽

Brain Changes ◽

Sectional Analysis ◽

Neurocognitive Decline

Abstract Type II diabetes (T2D) is associated with neurocognitive decline beyond normative aging, and thus older adults with T2D are at high risk for developing dementia. However, the extent to which similar deficits occur in prediabetic older adults is not well understood. While few studies have shown that prediabetic older adults experience some cognitive decline, further research is needed to determine the specific cognitive domains affected and the degree to which this decline occurs. Moreover, structural and functional brain changes that may occur with these deficits is currently unknown in this population. Therefore, the aim of this study was to assess cognitive function and brain health in prediabetic older adults. We conducted a cross-sectional analysis of older adults (aged 60-80) with prediabetes (FPG 6.1-7.0 mmol/L) and healthy aged-matched controls, examining 1) cognitive performance, 2) functional brain activation as measured by fMRI, and 3) structural measures such as volume of the hippocampus. Based on our cross-sectional analysis, prediabetic older adults show impaired cognition (e.g., memory), as well as decreased hippocampal volume and activation. Therefore, we conclude that older adults with prediabetes experience brain decline, and could benefit from lifestyle interventions to prevent or delay the onset of such decline.

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A Frailty Index from Next-of-Kin Data: A Cross-Sectional Analysis from the Mexican Health and Aging Study

BioMed Research International ◽

10.1155/2017/6069374 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Mario Ulises Pérez-Zepeda ◽

Matteo Cesari ◽

María Fernanda Carrillo-Vega ◽

Guillermo Salinas-Escudero ◽

Pamela Tella-Vega ◽

...

Keyword(s):

Older Adults ◽

Frailty Index ◽

Community Dwelling ◽

Next Of Kin ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Aging Study ◽

The Mean ◽

Number Of Visits ◽

Sectional Analysis

Objectives. To construct a frailty index from next-of-kin information of the last year of life of community-dwelling 50 years old or older adults and test its association with health services utilization. Methods. Cross-sectional analysis from next-of-kin data available from the last wave of the Mexican Health and Aging Study (MHAS). Measurements. Along with descriptive statistics, the frailty index (FI) was tested in regression models to assess its association with adverse outcomes previous to death: number of hospitalized days in the previous year and number of visits to a physician in the previous year, in unadjusted and adjusted models. Results. From a total of 2,649 individuals the mean of age was 74.8 (±11.4) and 56.3% (n = 1,183) were women. The mean of the FI was of 0.279 (±SD 0.131, R = 0.0–0.738) and distribution was biased to the right. There was a significant association (p < 0.001) between the FI and number of hospitalized days (β = 45.7, 95% CI 36.1–55.4, p < 0.001) and for the number of visits to a physician (β = 25.93, 95% CI 19.27–32.6, p < 0.001) both models adjusted for age and sex. Conclusion. The FI constructed with next-of-kin data showed similar characteristics to similar indexes of older adults. It was independently associated with health care use.

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The role of cognitive function in the relationship between age and health literacy: a cross-sectional analysis of older adults in Chicago, USA

BMJ Open ◽

10.1136/bmjopen-2014-007222 ◽

2015 ◽

Vol 5 (4) ◽

pp. e007222-e007222 ◽

Cited By ~ 21

Author(s):

L. C. Kobayashi ◽

S. G. Smith ◽

R. O'Conor ◽

L. M. Curtis ◽

D. Park ◽

...

Keyword(s):

Older Adults ◽

Health Literacy ◽

Cognitive Function ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Sectional Analysis ◽

The Relationship

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Relative Clinical and Cost Burden of Community-Acquired Pneumonia Hospitalizations in Older Adults in the United States—A Cross-Sectional Analysis

Vaccines ◽

10.3390/vaccines6030059 ◽

2018 ◽

Vol 6 (3) ◽

pp. 59 ◽

Cited By ~ 6

Author(s):

Omotola Olasupo ◽

Hong Xiao ◽

Joshua Brown

Keyword(s):

Older Adults ◽

Length Of Stay ◽

Disease Burden ◽

Preventive Treatment ◽

The United States ◽

Community Acquired Pneumonia ◽

Inpatient Mortality ◽

Cross Sectional ◽

The Mean ◽

Sectional Analysis

The relative burden of community-acquired pneumonia (CAP) in older adults (≥65 years old) compared to other serious diseases is important to prioritize preventive treatment. A retrospective analysis was conducted using the 2014 National Readmission Database to evaluate the length of stay, inpatient mortality, 30-day readmissions, and costs of CAP compared to diabetes mellitus (DM), myocardial infarction (MI), and stroke. 275,790 hospitalizations were analyzed and represented a national estimate of 616,300 hospitalizations, including 269,961 for CAP, 71,284 for DM, 126,946 for MI, and 148,109 for stroke. The mean length of stay in CAP was 5.2 days, which was higher than DM (4.6) and MI (4.3) but similar to stroke (5.6). The inpatient mortality risk was lower for DM (RR: 0.37, 95% CI: 0.29–0.46) but higher for MI (RR: 1.67, 95% CI: 1.50–1.85) and stroke (RR: 1.67, 95% CI: 1.51–1.83). The median costs for CAP ($7282) were higher compared to DM ($6217) but lower compared to MI ($14,802) and stroke ($8772). The 30-day readmission rate was 17% in CAP, which was higher compared to MI (15%) and stroke (11.5%) and lower compared to DM (20.3%). In patients with CAP, disease burden is on par with other serious diseases. CAP should be prioritized for prevention in older adults with strategies such as vaccination and smoking cessation.

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Sarcopenia is Associated Cognitive Impairment Mainly Due to Slow Gait Speed: Results from the Korean Frailty and Aging Cohort Study (KFACS)

10.20944/preprints201904.0240.v1 ◽

2019 ◽

Author(s):

Miji Kim ◽

Chang Won Won

Keyword(s):

Cohort Study ◽

Cognitive Impairment ◽

Cognitive Function ◽

Gait Speed ◽

Final Analysis ◽

Community Dwelling ◽

Disease Assessment ◽

Cross Sectional ◽

Cognitive Domains ◽

Sectional Analysis

Cognitive impairment and sarcopenia may share common risk factors and pathophysiological pathways. This study was performed to examine the association between impairments in specific cognitive domains and sarcopenia (and its defining components) in a large group of community-dwelling older adults. Cross-sectional analysis was performed on the baseline data of 3,014 adults aged 70–84 years enrolled in the Korean Frailty and Aging Cohort Study (KFACS). The final analysis included 1,887 adults underwent dual-energy X-ray absorptiometry and cognitive function assessments. Those with disability in activities of daily living, dementia, severe cognitive impairment, Parkinson’s disease, musculoskeletal complaints, neurological disorders, or who were illiterate were excluded. Cognitive function was assessed using the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet, the Frontal Assessment Battery. For sarcopenia, we used the diagnostic criteria of the Asian Working Group for Sarcopenia. The prevalence of sarcopenia was 9.6% for men and 7.6% for women. Sarcopenia (odds ratio [OR] 1.76, 95% confidence interval [CI] 1.04–2.99) and slow gait speed (OR 2.58, 95% CI 1.34–4.99) were associated with cognitive impairment in men. Only slow gait speed (OR 1.88, 95% CI 1.05–3.36) was associated with cognitive impairment in women. Sarcopenia is associated with cognitive impairment mainly due to slow gait speed. Our results suggested that cognitive impairment domains, such as processing speed and executive function, are associated with sarcopenia-related slow gait speed.

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Physical Health and Cognitive Function Independently Contributed to Functional Disability among Chinese Older Adults: Data from Two Asian Metropolises

Journal of Aging Research ◽

10.4061/2011/960848 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Lei Feng ◽

Tze-Pin Ng ◽

Yanling He ◽

Chunbo Li ◽

Ee-Heok Kua ◽

...

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Physical Health ◽

Functional Disability ◽

Population Based ◽

Cross Sectional ◽

Chinese Older Adults ◽

Ageing Study ◽

Sectional Analysis ◽

State Examination

Objective. We aimed to examine the independent contributions of physical health and cognitive function to disability among Chinese older adults living in two Asian metropolises and explore the potential influences of environment.Design and Participants. Cross-sectional analysis based on data from two population-based studies: the Shanghai Survey of Alzheimer's Disease and Dementia (n=4639) and the Singapore Longitudinal Ageing Study (n=2397). Disability was defined as needing help in at least one activity of daily living.Results. The prevalence of functional disability was higher in Shanghai sample (5%) than that in Singapore sample (1.8%). Number of chronic diseases, self-rated health status, cognitive function (measured by the Mini-Mental State Examination), and environment (Singapore versus Shanghai) significantly contributed to functional disability independent of each other. The adjusted Odds Ratio was 1.35 (95%CI 1.22–1.50), 2.85 (95% CI 2.36–3.43), 0.89 (95% CI 0.85–0.94), and 0.68 (95% CI 0.48–0.96), respectively. The strength of associations between health variables and disability appeared to be influenced by environment.Conclusion. Physical health and cognitive function independently contributed to functional disability. The associations are modulated by environmental factors.

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Association between residential greenness and cognitive function: analysis of the Chinese Longitudinal Healthy Longevity Survey

BMJ Nutrition, Prevention & Health ◽

10.1136/bmjnph-2019-000030 ◽

2019 ◽

Vol 2 (2) ◽

pp. 72-79 ◽

Cited By ~ 5

Author(s):

Anna Zhu ◽

Chenkai Wu ◽

Lijing L Yan ◽

Chih-Da Wu ◽

Chen Bai ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Cognitive Function ◽

Linear Regression ◽

Mmse Score ◽

Mixed Effects ◽

Cross Sectional ◽

Linear Mixed Effects ◽

Healthy Longevity ◽

Sectional Analysis

IntroductionProximity to vegetated green space has been linked to better physical and mental health. However, the relationship between residential greenness and cognitive function and its decline among older adults is not clear in large cohort studies.MethodsOur study used the 2000, 2002, 2005, 2008 and 2011 wave of the Chinese Longitudinal Healthy Longevity Survey. We calculated the Normalised Difference Vegetation Index (NDVI) using a 500 m radius around participants’ residential addresses. Mini-Mental State Examination (MMSE) was applied to measure cognitive function. Our study included the cross-sectional analysis using the linear regression, and logistical regression, and also the longitudinal analysis using the linear mixed effects regression, and mixed effects logistic regression. Our study also conducted a sensitivity analysis using the survey-weighted regression. Additionally, our study participants were categorised into those living in areas of positive and negative changes in NDVI in relation to MMSE. All regression models were adjusted for a range of covariates.ResultsAmong 38 327 participants at baseline, the mean MMSE score was 21. Annual average NDVI ranged from −0.11 to 0.76. In the cross-sectional analysis, each 0.1-unit increase in NDVI was associated with a 0.23-point increase in MMSE score (95% CI 0.16 to 0.29) in the linear regression, and an OR of 0.94 (95% CI 0.92 to 0.96) of having cognition impairment in the logistic regression. In the second analysis, looking at changes in NDVI and MMSE score, compared with the participants living in areas with an increase in NDVI, those living in areas with a decrease in greenness had an OR of 1.25 (95% CI 1.18 to 1.34) of a decrease in MMSE, and an OR of 0.90 (95% CI 0.84 to 0.96) of an increase in MMSE. In the longitudinal analysis, we found a significantly weak association (coefficient 0.069, 95% CI 0.0048 to 0.13) in the linear mixed effects regression, but not in the mixed effects logistic regression.ConclusionWe found evidence of an association between higher residential greenness and better cognitive function among older adults. Our finding provides insight into neurodegeneration and has implications for preventing dementia and Alzheimer’s disease in China.

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Adherence to the Australian Dietary Guidelines Is Not Associated with Brain Structure or Cognitive Function in Older Adults

Journal of Nutrition ◽

10.1093/jn/nxaa052 ◽

2020 ◽

Vol 150 (6) ◽

pp. 1529-1534

Author(s):

Fateme Zabetian-Targhi ◽

Velandai K Srikanth ◽

Richard Beare ◽

Chris Moran ◽

Wei Wang ◽

...

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Brain Structure ◽

Linear Models ◽

Brain Mri ◽

Dietary Guidelines ◽

Brain Health ◽

Cross Sectional ◽

Product Term ◽

The Mean

ABSTRACT Background Cognitive dysfunction is common in older adults, particularly in those with type 2 diabetes (T2D). Higher adherence to the Dietary Guidelines for Americans is associated with better brain health. However, it is unclear if adherence to the Australian Dietary Guidelines (ADG) is associated with cognition or brain structure in older adults. Objective The aims of this study were to 1) examine the relation between adherence to the ADG, cognition, and brain MRI and 2) determine whether T2D modifies any associations. Methods The Cognition and Diabetes in Older Tasmanians Study is a cross-sectional study in 688 people (n = 343 with T2D) aged 55–90 y. A validated 80-item food-frequency questionnaire was used to assess dietary intake. Adherence to the 2013 ADG was estimated using the Dietary Guidelines Index (DGI). Cognitive function in multiple domains was assessed with a comprehensive battery of neuropsychological tests and brain structure with MRI. Multivariable linear models were used to assess the associations between DGI, cognitive z scores, and brain structure. Effect modification for T2D was examined with a DGI × T2D product term. Results The mean age of the sample was 69.9 y (SD: 7.4 y), with 57.1% men. The mean DGI was 54.8 (SD: 10.7; range: 24.1–84.6). No associations were observed between the Australian DGI and cognition or brain MRI measures. T2D did not modify any associations (P > 0.05). Conclusions This is the first study to investigate associations between adherence to the ADG and brain health in the older adults with and without T2D. Future prospective studies are required to clarify if there are long-term associations.

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