OLDER VETERANS WITH TYPE 2 DIABETES: A1C AND COGNITIVE FUNCTION

• Published in: Innovation in aging 2017-07, Vol.1 (suppl_1), p.470-470
• Main Authors: Lee, P., Guerrero-Berroa, E., Schmeidler, J., Schnaider-Beeri, M., West, R., Sano, M., Alexander, N., Silverman, J.M.
• Format: Article
• Language: English
• Subjects: Abstracts
• ISSN: 2399-5300; 2399-5300
• DOI: 10.1093/geroni/igx004.1674

Poor glycemic control (i.e., high A1c) among older adults with type 2 diabetes (DM) is associated with high risk of cognitive impairment across various domains of cognitive assessments. Older Veterans with DM have not been well studied. We hypothesized that high A1c is associated with worse executive function among older Veterans with DM. We performed preliminary analysis of the baseline data from 61 Veterans with DM (aged 60 years or older) recruited from 2 VA health systems for a computerized cognitive training study. None had dementia diagnosis or Clinical Dementia Rating scale ≥1. A finger-stick blood sample was analyzed using a point-of-care A1c analyzer to obtain A1c results. Five cognitive domains were assessed - Episodic Memory, Executive Function, Attention/Working Memory, Language/Semantic Categorization, and Psychomotor Speed. The association between A1c and cognition was examined using multiple linear regressions, adjusting for age and education. For 61 Veterans (2 females), means were age 70 years, 14 years education, and 7.4% A1c. A1c was significantly associated with cognition only for Executive Function at one VA center (n=31, mean 7.9% ± SD 1.4, range 6–11%). Higher A1c was associated with better executive performance (β = 0.40, t = 3.61, p = 0.001, partial r = 0.59), explaining 0.31 of the variability in performance (R 2  = 0.41). This preliminary result of unexpected positive association of executive function with higher A1c may reflect recruitment of Veterans with high and variable A1c at that center. Ongoing recruitment and increased sample size will be needed to verify this result.