Diabetes and Prediabetes Inhibit Reversion from Mild Cognitive Impairment to Normal Cognition |
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| Affiliation: | 1. Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu City, Aichi, Japan;2. Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan;3. Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan;4. Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu City, Aichi, Japan;1. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy;2. Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy;3. Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy;4. Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy;1. Department of Family and Geriatric Medicine, University of Louisville School of Medicine, Louisville, KY, USA;2. Multi-Facility Director, Orlando, FL, USA;3. Department of Medicine/Geriatric Medicine Division, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA;4. Medical Director, Long Term Care, Buckeye Health Plan, Akron, OH, USA;5. Department of Family and Community Medicine, Eastern Virginia Medical School, Norfolk, VA, USA;6. Board of Pharmacy Specialties, Alexandria, VA, USA;7. Department of Geriatrics, FSU College of Medicine, Tallahassee, FL, USA;1. Behavioral Health Council, AMDA, Columbia, MD, USA;2. Geriatric Psychiatry Consultation and Training, Denver, CO, USA;3. Director of Behavioral Health Policy and Regulations, TeamHealth, Accord, NY, USA;1. University of Waterloo Department of Kinesiology, Waterloo, Ontario, Canada;2. Simon Fraser University, Department of Gerontology, Vancouver, British Columbia, Canada;3. University of Alberta, Faculty of Nursing, Edmonton, Alberta, Canada;4. University of Manitoba, Department of Food and Human Nutritional Sciences, Winnipeg, Manitoba, Canada;5. Université de Moncton, Faculté des sciences de la santé et des services communautaires, Moncton, New Brunswick, Canada;6. Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Ontario, Canada |
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| Abstract: | ObjectivesDiabetes and prediabetes contribute to an increased risk of cognitive decline and dementia. Currently, it remains unclear whether elevated blood HbA1c levels, including prediabetes levels, affect reversion from mild cognitive impairment (MCI) to normal cognition. This study, therefore, aimed to examine the prospective associations of diabetes and prediabetes with reversion from MCI to normal cognition among community-dwelling older adults.DesignLongitudinal cohort study with a 4-year follow-up.Setting and ParticipantsCommunity-dwelling older adults with MCI, aged ≥65 years at baseline (n = 787).MethodsParticipants’ medical history of diabetes and blood HbA1c levels at baseline were assessed, and they were classified as control, prediabetes, and diabetes. Objective cognitive screening was performed using a multicomponent neurocognitive test at baseline and follow-up. Reversion from MCI to normal cognition over 4 years was determined. In the longitudinal analysis, we performed multiple imputations to adjust for a selection bias and loss of information.ResultsThe reversion rates of MCI in the control, prediabetes, and diabetes groups were 63.4%, 55.6%, and 42.9%, respectively, in the completed follow-up dataset, and 54.6%, 47.2%, and 34.1%, respectively, in the imputed dataset. Multivariate logistic regression showed that diabetes decreases the probability of MCI reversion both before and after multiple imputations [odds ratio (OR) 0.37; 95% confidence interval (CI) 0.18–0.74 for before imputation, OR 0.37; 95% CI 0.19–0.72 for after imputation]. Furthermore, prediabetes also showed significantly decreased probabilities of MCI reversion both before and after multiple imputations (OR 0.57; 95% CI 0.34–0.94 for before imputation, OR 0.60; 95% CI 0.37–0.97 for after imputation).Conclusions and ImplicationsDiabetes and prediabetes could inhibit MCI reversion. Adequate glycemic control may be effective in enhancing the reversion from MCI to normal cognition in a community setting. |
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| Keywords: | Community-dwelling diabetes HbA1c MCI prediabetes |
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