High AIC Levels are linked to lower cognitive function

High A1C levels are linked to lower cognitive function in individuals with Type 2 diabetes, according to the latest findings from the ACCORD-MIND trial.

Diabetes is associated with cognitive decline and dementia but the relationship between the degree of hyperglycaemia and cognitive status is unclear, the researchers wrote in their paper published in Diabetes Care.

Using data from the Memory in Diabetes substudy of the Action to Control Cardiovascular Risk in Diabetes (ACCORD-MIND) trial the researchers studied 2977 subjects who had A1C and fasting plasma (FPG) glucose levels measured and had completed four cognitive function tests.

The researchers found that as glycaemic control declined, so did the scores on all four tests. For example, a 1% increase in HbA1c was associated with a 1.75-point drop in the DSST score (p < 0.0001), 0.20-point fall in the MMSE (p < 0.0001), a 0.11-point decrease in the memory score (p = 0.0142), and worse score on the Stroop Test (p = 0.0094). FPG was not associated with test performance.

The observed effect of a 1% change in A1C on test scores is clearly small, but such an effect may be clinically important, the authors said.

For example, in the same sample every 1-year increase in age was associated with a 0.7-point decrease in DSST score and therefore, the difference in DSST per 1% higher A1C corresponds to an age difference of up to 2 years, they explained.

Strategies to lower A1C levels or prevent their rise may favourably affect cognitive function, the research team concluded.

Diabetes Care 2009;32:221-226.

 

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