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

Autor(es)

J.G. Souza ^[1] ; D.S. Farias-Itao ^[2] ; M.J.R. Aliberti ; T.S. Alexandre ^[4] ; C. Szlejf ^[5] ; C.P. Ferri ^[6] ; M.F. Lima-Costa ^[7] ; C.K. Suemoto ^[8]

Afiliação do(s) autor(es)

^[1] Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo. Serviço de Geriatria. Laboratório de Investigação Médica no Envelhecimento (LIM-66) - Brasil

^[2] Universidade de São Paulo. Faculdade de Medicina. Departamento de Patologia - Brasil

^[4] Universidade Federal de São Carlos. Departamento de Gerontologia - Brasil

^[5] Hospital Israelita Albert Einstein - Brasil

^[6] Departamento de Psiquiatria, Universidade Federal de São Paulo - Brasil

^[7] Instituto de Pesquisa René Rachou, Fundação Oswaldo Cruz - Brasil

^[8] Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo. Serviço de Geriatria. Laboratório de Investigação Médica no Envelhecimento (LIM-66) - Brasil

• Tipo de documento: Artigo Científico
• Fonte: Brazilian Journal of Medical and Biological Research; v. 57, 2024-02-19.

Resumo

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. (AU)

• Processo FAPESP: 17/24066-1 - Caracterização do perfil da resposta inflamatória no tecido adiposo perivascular associada à doença arterial coronariana: um estudo de autópsia
• Beneficiário: Daniela Souza Farias Itao
• Modalidade de apoio: Bolsas no Brasil - Doutorado