Glycaemia and cognitive impairment: Guangzhou Biobank Cohort Study 27. Gallagher D, Visser M, Sepúlveda D, Pierson RN, Harris T, Heymsfield SB. How useful is body mass index for comparison of body fatness across age, sex, and ethnic groups? Am J Epidemiol 1996; 143: 228–39. 28. Holland J, Bandelow S, Hogervorst E. Testosterone levels and cognition in elderly men: a review. Maturitas 2011; 69: 322–37. 29. Harvey J, Shanley LJ, O’Malley D, Irving AJ. Leptin: a potential cognitive enhancer? Biochem Soc Trans 2005; 33(Pt 5): 1029–32.
Age and Ageing 2015; 44: 65–71 doi: 10.1093/ageing/afu088 Published electronically 8 July 2014
30. Arnold AM, Newman AB, Cushman M, Ding J, Kritchevsky S. Body weight dynamics and their association with physical function and mortality in older adults: the Cardiovascular Health Study. J Gerontol A Biol Sci Med Sci 2010; 65: 63–70. Received 28 April 2013; accepted in revised form 7 May 2014
© The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: [email protected]
A. C. JAGIELSKI1,2, C. Q. JIANG3, L. XU4, S. TAHERI2,5,6,7, W. S. ZHANG3, K. K. CHENG1, T. H. LAM4, G. N. THOMAS1,8 1
Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK Birmingham and Black Country NIHR CLAHRC, Birmingham, UK 3 Guangzhou Number 12 People’s Hospital, Guangzhou, China 4 School of Public Health, The University of Hong Kong, Hong Kong, China 5 Department of Medicine, Weill Cornell Medical College in New Youk, NY, USA 6 Department of Medicine, Weill Cornell Medical College in Qatar, Doha, Qatar 7 Department of Medicine, King’s College London, London, UK 8 Mannheim Medical Faculty, Institute of Public Health, Social and Preventive Medicine, University of Heidelberg, Mannheim 68135, Germany 2
Address correspondence to: S. Taheri, Department of Medicine, Weill Cornell Medical College in Qatar, Qatar Foundation – Education City, PO Box 2, 4144 Doha, Qatar. Tel: (+974) 4492 8998; Fax: (+974) 55696499. Email: [email protected]; G. N. Thomas, School of Health & Population Sciences, University of Birmingham, Public Health Building, Edgbaston, Birmingham B15 2TT, UK. Email: [email protected]
Abstract Aims: an association between T2DM and cognitive impairment has been reported among Western populations, but data are limited in other settings. We investigated the cross-sectional association between fasting blood glucose (FBG) and cognition in an older Chinese population. Methods: the Guangzhou Biobank Cohort Study included 27,971 individuals (50–96 years, mean age 61.5 years, 72% female) with measures of cognitive function assessed using modified Delayed Word Recall Test (DWRT) and Mini-Mental State Examination (MMSE). Fasting glucose and lipids, and potential confounders were measured. Results: after adjustment for potential confounders, the risk for cognitive impairment as measured by DWRT, significantly increased [odds ratio (OR) = 1.18, 95% CI 1.00–1.40] but the association was of borderline significance when measured by MMSE (OR = 1.04, 95% CI 0.73–1.47) in those with diabetes relative to those without diabetes. Fasting blood glucose was significantly negatively associated with cognitive function as measured by DWRT but not MMSE, with an increase of 1 mmol/l of FBG associated with a decrease of 0.02 in DWRT (P < 0.05, 95% CI −0.03 to −0.002) and 0.03 in MMSE score (P = 0.114, 95% CI −0.06–0.01).
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Downloaded from http://ageing.oxfordjournals.org/ at Serials Department on July 27, 2015
Glycaemia is associated with cognitive impairment in older adults: the Guangzhou Biobank Cohort Study
A. C. Jagielski et al. Conclusions: an FBG level indicative of T2DM was associated with increased risk for cognitive impairment. The findings also demonstrate that glycaemia is continuously associated with cognitive impairment, suggesting that dysfunction is associated with increasing glucose levels even in the normoglycaemic range. Keywords: cognition, glycaemia, type 2 diabetes mellitus, older adult
Introduction
Patients and methods The GBCS baseline data were collected during September 2003 to January 2008; the sample for the present study included 27,971 individuals. Participants were randomly recruited to the GBCS from an unofficial organisation affiliated with the local government: the ‘Guangzhou Health and Happiness Association for the Respectable Elders’ (GHHARE) open to all aged ≥50 years. Further information describing the GBCS has been previously reported [8]. Participants were aged ≥50 years, ambulatory, capable of consenting and not receiving treatment of life-threatening conditions. All participants gave informed consent before data were collected using a computer-based questionnaire by face-to-face interviews conducted by trained nurses at the Guangzhou Number 12 Hospital. The study was approved by the Guangzhou Medical Ethics Committee of the Chinese Medical Association in Guangzhou, China.
66
Cognitive function was assessed using modified versions of the Delayed Word Recall Test (DWRT) [9] and MMSE. The DWRT involves presenting 10 simple Chinese words (soy sauce, arm, letter, chairman, ticket, grass, corner, stone, book and stick) to participants, who were asked to recall the words. This procedure was repeated three times, then after 5 min, participants were asked to freely recall as many words as possible. Participants who successfully recalled one word were given a score of 1, with a maximum score of 10. The scores from this fourth repetition were analysed as the DWRT score. Cognitive impairment was defined as DWRT score
Age and Ageing 2015; 44: 65–71 doi: 10.1093/ageing/afu088 Published electronically 8 July 2014
30. Arnold AM, Newman AB, Cushman M, Ding J, Kritchevsky S. Body weight dynamics and their association with physical function and mortality in older adults: the Cardiovascular Health Study. J Gerontol A Biol Sci Med Sci 2010; 65: 63–70. Received 28 April 2013; accepted in revised form 7 May 2014
© The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: [email protected]
A. C. JAGIELSKI1,2, C. Q. JIANG3, L. XU4, S. TAHERI2,5,6,7, W. S. ZHANG3, K. K. CHENG1, T. H. LAM4, G. N. THOMAS1,8 1
Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK Birmingham and Black Country NIHR CLAHRC, Birmingham, UK 3 Guangzhou Number 12 People’s Hospital, Guangzhou, China 4 School of Public Health, The University of Hong Kong, Hong Kong, China 5 Department of Medicine, Weill Cornell Medical College in New Youk, NY, USA 6 Department of Medicine, Weill Cornell Medical College in Qatar, Doha, Qatar 7 Department of Medicine, King’s College London, London, UK 8 Mannheim Medical Faculty, Institute of Public Health, Social and Preventive Medicine, University of Heidelberg, Mannheim 68135, Germany 2
Address correspondence to: S. Taheri, Department of Medicine, Weill Cornell Medical College in Qatar, Qatar Foundation – Education City, PO Box 2, 4144 Doha, Qatar. Tel: (+974) 4492 8998; Fax: (+974) 55696499. Email: [email protected]; G. N. Thomas, School of Health & Population Sciences, University of Birmingham, Public Health Building, Edgbaston, Birmingham B15 2TT, UK. Email: [email protected]
Abstract Aims: an association between T2DM and cognitive impairment has been reported among Western populations, but data are limited in other settings. We investigated the cross-sectional association between fasting blood glucose (FBG) and cognition in an older Chinese population. Methods: the Guangzhou Biobank Cohort Study included 27,971 individuals (50–96 years, mean age 61.5 years, 72% female) with measures of cognitive function assessed using modified Delayed Word Recall Test (DWRT) and Mini-Mental State Examination (MMSE). Fasting glucose and lipids, and potential confounders were measured. Results: after adjustment for potential confounders, the risk for cognitive impairment as measured by DWRT, significantly increased [odds ratio (OR) = 1.18, 95% CI 1.00–1.40] but the association was of borderline significance when measured by MMSE (OR = 1.04, 95% CI 0.73–1.47) in those with diabetes relative to those without diabetes. Fasting blood glucose was significantly negatively associated with cognitive function as measured by DWRT but not MMSE, with an increase of 1 mmol/l of FBG associated with a decrease of 0.02 in DWRT (P < 0.05, 95% CI −0.03 to −0.002) and 0.03 in MMSE score (P = 0.114, 95% CI −0.06–0.01).
65
Downloaded from http://ageing.oxfordjournals.org/ at Serials Department on July 27, 2015
Glycaemia is associated with cognitive impairment in older adults: the Guangzhou Biobank Cohort Study
A. C. Jagielski et al. Conclusions: an FBG level indicative of T2DM was associated with increased risk for cognitive impairment. The findings also demonstrate that glycaemia is continuously associated with cognitive impairment, suggesting that dysfunction is associated with increasing glucose levels even in the normoglycaemic range. Keywords: cognition, glycaemia, type 2 diabetes mellitus, older adult
Introduction
Patients and methods The GBCS baseline data were collected during September 2003 to January 2008; the sample for the present study included 27,971 individuals. Participants were randomly recruited to the GBCS from an unofficial organisation affiliated with the local government: the ‘Guangzhou Health and Happiness Association for the Respectable Elders’ (GHHARE) open to all aged ≥50 years. Further information describing the GBCS has been previously reported [8]. Participants were aged ≥50 years, ambulatory, capable of consenting and not receiving treatment of life-threatening conditions. All participants gave informed consent before data were collected using a computer-based questionnaire by face-to-face interviews conducted by trained nurses at the Guangzhou Number 12 Hospital. The study was approved by the Guangzhou Medical Ethics Committee of the Chinese Medical Association in Guangzhou, China.
66
Cognitive function was assessed using modified versions of the Delayed Word Recall Test (DWRT) [9] and MMSE. The DWRT involves presenting 10 simple Chinese words (soy sauce, arm, letter, chairman, ticket, grass, corner, stone, book and stick) to participants, who were asked to recall the words. This procedure was repeated three times, then after 5 min, participants were asked to freely recall as many words as possible. Participants who successfully recalled one word were given a score of 1, with a maximum score of 10. The scores from this fourth repetition were analysed as the DWRT score. Cognitive impairment was defined as DWRT score
