scholarly journals Eight-Year Longitudinal Associations of the Onset of Prediabetes and Diabetes with Cognitive Function Decline Among Chinese Adults Aged 45 Years or Older

Author(s):  
Xiaojie Wang ◽  
Xiuwen Li ◽  
Wanxin Wang ◽  
Guangduoji Shi ◽  
Ruipeng Wu ◽  
...  

Abstract Background With the population aging, diabetes and cognitive function decline are increasingly common among older adults worldwide. However, the evidence about the effects and mechanism of prediabetes and diabetes on cognitive function is still limited. The purposes of this longitudinal study were to estimate the longitudinal associations of the onset of prediabetes and diabetes status with cognitive function among Chinese adults aged 45 years or older during an 8-year period; to estimate the clinical risk factors associated with cognitive function among patients with prediabetes and diabetes. Methods Participants were enrolled between 2011 and 2012, and followed up between 2018 and 2019 in the China Health and Retirement Longitudinal Study. In this study, we focused on newly diagnosed diabetic status, and those diagnosed with diabetes before or not providing fasting blood samples were excluded. Diabetic status was assessed according to the 2010 American Diabetes Association (ADA) guidelines. The general cognitive function, demographic characteristics, and clinical and biochemical factors were also measured. Results At baseline, 849 (21.3%) participants were first diagnosed with prediabetes, and 444 (11.1%) were diabetes patients. After adjusting for age, gender, marital status, education level, ever smoking, ever drinking, self-comment about health, hypertension, dyslipidemia, depressive symptoms, cognitive function, and clinical and biochemical measurements at baseline, diabetes status was a significant risk factor for subsequent cognitive decline (unstandardized β estimate=-0.47, 95% CI=-0.91~-0.04). Further stratification analyses found that only triglyceride concentrations were negatively associated with cognitive function among prediabetes patients (unstandardized β estimate=-0.004, 95% CI=-0.007~-0.001), and only creatine reactive protein was significantly associated with cognitive decline among diabetes patients (unstandardized β estimate=-0.065, 95% CI=-0.122~-0.009). Conclusions There is a positive longitudinal association between the onset of diabetes and cognitive decline among middle-aged and elderly Chinese. The management of triglycerides through lifestyle modification for prediabetes and specific adjunctive anti-inflammatory therapy for diabetes could benefit cognitive performance.

2021 ◽  
Author(s):  
Carlos Gómez Martínez ◽  
Nancy Babio ◽  
Jordi Julvez ◽  
Nerea Becerra Tomás ◽  
Miguel A. Martínez González ◽  
...  

Abstract BACKGROUND: Type 2 diabetes was related with larger cognitive decline. However, other glycemic dysregulations showed inconsistent results. Our aim was to examine longitudinal associations between diabetes/glycemic status and cognitive function in older adults with metabolic syndrome. METHODS: We conducted a 2-year prospective cohort study (n=6,874) within the framework of the PREDIMED-Plus study. The participants (with overweight/obesity and metabolic syndrome; mean age 64.9 years; 48.5% women) completed a battery of 8 cognitive tests, and a global cognitive function Z-score (GCF) was estimated. Participants were categorized by diabetes status (no-diabetes, prediabetes, and <5 or ≥5-year diabetes duration), and control. At baseline, insulin resistance (HOMA-IR) and glycated hemoglobin (HbA1c) levels were measured and antidiabetic medications were recorded. Linear and logistic regression models, adjusted by potential confounders, were fitted to assess associations between glycemic status and changes in cognitive function. RESULTS: Prediabetes status was unrelated to cognitive decline. However, compared to participants without diabetes, those with ≥5-year diabetes duration had greater reductions in the GCF (β=-0.11 [95%CI -0.16;-0.06]), processing speed and executive function measurements. Inverse associations were observed between baseline HOMA-IR and changes in the GCF (β=-0.0094 [95%CI -0.0164;-0.0023]), but also between HbA1c levels and changes in the GCF (β=-0.0610 [95%CI -0.0889;-0.0331]), the Mini-Mental test, and other executive function tests. Poor diabetes control was inversely associated with phonologic fluency. Sulfonylureas, but especially insulin use, were related to cognitive decline.CONCLUSIONS: Insulin resistance, diabetes status, longer diabetes duration, poor glycemic control, and insulin treatment were associated with worsening cognitive function at short-term in a population at high cardiovascular risk.TRIAL REGISTRATION: ISRCTN, ISRCTN89898870. Registered 28 May 2014 - Retrospectively registered, http://www.isrctn.com/ISRCTN89898870


2021 ◽  
pp. 1-8
Author(s):  
Bin Yu ◽  
Andrew Steptoe ◽  
Yongjie Chen ◽  
Xiaohua Jia

Abstract Background Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults. Methods This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. Results Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = −0.03, p < 0.01; mental status: β = −0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = −0.05, p < 0.001; mental status: β = −0.03, p < 0.01) even after controlling for loneliness and all confounding variables. Conclusions Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.


2020 ◽  
Vol 9 (11) ◽  
pp. 3735
Author(s):  
Sook Ling Leong ◽  
Ian H. Robertson ◽  
Brian Lawlor ◽  
Sven Vanneste

Epidemiological studies have produced conflicting results regarding the associations between the use of different hypertensive drugs and cognition. Data from the Irish Longitudinal Study on Ageing (TILDA), a nationwide prospective longitudinal study of adults aged 50 or more years, was used to explore the associations between hypertensive status, categories of antihypertensive and cognitive function controlling for age, education, and other demographic and lifestyle factors. The study sample included 8173 participants. ANCOVAs and multivariate regressions were used to assess the cross-sectional and longitudinal associations between cognitive function and hypertension status and the different categories of hypertensive medication. Hypertension was not associated with decline in global cognitive and executive functions and were fully explained by age and education. Different hypertensive medications were not associated with cognitive function. Consistent with previous studies, changes in cognition can largely be explained by age and education. The use of antihypertensive medications is neither harmful nor protective for cognition.


Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 1183 ◽  
Author(s):  
Zumin Shi ◽  
Tahra El-Obeid ◽  
Malcolm Riley ◽  
Ming Li ◽  
Amanda Page ◽  
...  

We aimed to examine the association between chili intake and cognitive function in Chinese adults. This is a longitudinal study of 4852 adults (age 63.4 ± 7.7) attending the China Health and Nutrition Survey during 1991 and 2006. Cognitive function was assessed in 1997, 2000, 2004 and 2006. In total, 3302 completed cognitive screening tests in at least two surveys. Chili intake was assessed by a 3-day food record during home visits in each survey between 1991 and 2006. Multivariable mixed linear regression and logistic regression were used. Chili intake was inversely related to cognitive function. In fully adjusted models, including sociodemographic and lifestyle factors, compared with non-consumers, those whose cumulative average chili intake above 50 g/day had the regression coefficients (and 95% CI) for global cognitive function of −1.13 (−1.71–0.54). Compared with non-consumers, those with chili consumption above 50 g/day had the odds ratio (and 95% CI) of 2.12(1.63–2.77), 1.56(1.23–1.97) for self-reported poor memory and self-reported memory decline, respectively. The positive association between chili intake and cognitive decline was stronger among those with low BMI than those with high BMI. The longitudinal data indicate that higher chili intake is positively associated with cognitive decline in Chinese adults in both genders.


Author(s):  
Wonjeong Chae ◽  
Eun-Cheol Park ◽  
Sung-In Jang

Background The growing aging population is a global phenomenon and a major public health challenge. Among Organization for Economic Co-operation and Development countries, Korea is the fastest aging country. We aimed to investigate the relationship between changes in quality of life (QOL) and cognitive function in older adults. Method: Data from the Korean Longitudinal Study of Aging collected from 2008 to 2016 were used. In 3453 participants (men: 1943; women: 1541), QOL was measured by three aspects: general, financial, and familial. Changes in QOL status were assessed by four categories: remained poor, worsened, improved, and remained good. The level of cognitive function was measured by the Mini-Mental State Examination score (MMSE, normal range cut-off value: 24 or above). For the statistical analysis, the generalized equation model (GEE) was performed. Results: For all three aspects of QOL measured, participants whose QOL score remained poor were associated with cognitive decline that their odds ratios (OR) were statistically significant (general: OR = 1.33; familial: OR = 1.39; financial: OR = 1.40). For subgroup analysis by gender, the highest OR in men was the financial aspect of QOL (OR = 1.45); in women, the highest OR was the familial aspect of QOL (OR = 1.75). Conclusion: This study showed an association between QOL and cognitive function in a Korean elderly population. Our findings suggest that QOL measurements with a gender-specific approach can be used as a tool to detect cognitive changes in older adults and help prevent or delay cognitive decline.


2012 ◽  
Vol 42 (10) ◽  
pp. 2057-2069 ◽  
Author(s):  
C. R. Gale ◽  
M. Allerhand ◽  
I. J. Deary

BackgroundCross-sectional surveys of older people commonly find associations between higher levels of depressive symptoms and poorer cognitive performance, but the direction of effect is unclear. We examined whether there was a bidirectional relationship between depressive symptoms and general cognitive ability in non-demented older people, and explored the role of physical health, smoking, exercise, social class and education as potential confounders of this association and as possible determinants of the rate of change of cognitive decline and depressive symptoms.MethodThe English Longitudinal Study of Ageing consists of people aged 50 years and over. Cognitive function and self-reported depressive symptoms were measured in 2002–2003, 2004–2005, 2006–2007 and 2008–2009. We fitted linear piecewise models with fixed knot positions to allow different slopes for different age groups. Analyses are based on 8611 people.ResultsMean cognitive function declined with age; there was no trend in the trajectory of depressive symptoms. Better cognitive function was associated with less depression up to the age of 80 years. Greater depression was associated with a slightly faster rate of cognitive decline but only in people aged 60–80 years. There were no consistent associations across age groups between sex, smoking, education, social class, exercise or number of chronic physical illnesses and the rate of change of cognitive decline or depressive symptoms.ConclusionsIn this longitudinal study of older people, there was no consistent evidence that being more depressed led to an acceleration in cognitive decline and no support for the hypothesis that there might be reciprocal dynamic influences between cognitive ability and depressive symptoms.


Author(s):  
Atsushi Motohiro ◽  
Takafumi Abe ◽  
Kenta Okuyama ◽  
Keiichi Onoda ◽  
Tomoko Ito ◽  
...  

Although neighborhood environmental factors have been found to be associated with cognitive decline, few longitudinal studies have focused on their effect on older adults living in rural areas. This longitudinal study aimed to investigate the role of neighborhood environmental factors in cognitive decline among rural older adults. The data of 485 older adults aged ≥60 years who were living in Unnan City in Japan and had participated in two surveys conducted between 2014 and 2018 were analyzed. Cognitive function was assessed using the Cognitive Assessment for Dementia, iPad version 2. Elevation, hilliness, residential density, and proximity to a community center were determined using geographic information system. We applied a generalized estimating equation with odds ratios (OR) and 95% confidence intervals (CIs) of cognitive decline in the quartiles of neighborhood environmental factors. A total of 56 (11.6%) participants demonstrated a decrease in cognitive function at follow up. Elevation (adjusted OR 2.58, 95% CI (1.39, 4.77) for Q4 vs. Q1) and hilliness (adjusted OR 1.93, 95% CI (1.03, 3.63) for Q4 vs. Q1) were associated with a higher likelihood of cognitive decline. The second quartiles of residential density showed significantly lower likelihoods of cognitive decline compared with the first quartiles (adjusted OR 0.36, 95% CI (0.19, 0.71) for Q2 vs. Q1). Thus, an elevated hilly environment and residential density predicted cognitive decline among rural older adults.


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