RT Journal Article
T1 Glycemic Dysregulations Are Associated With Worsening Cognitive Function in Older Participants at High Risk of Cardiovascular Disease: Two-Year Follow-up in the PREDIMED-Plus Study
A1 Gomez-Martinez, Carlos
A1 Babio, Nancy
A1 Julvez, Jordi
A1 Becerra-Tomas, Nerea
A1 Martinez-Gonzalez, Miguel A.
A1 Corella, Dolores
A1 Castaner, Olga
A1 Romaguera, Dora
A1 Vioque, Jesus
A1 Alonso-Gomez, Angel M.
A1 Warnberg, Julia
A1 Martinez, Jose A.
A1 Serra-Majem, Luis
A1 Estruch, Ramon
A1 Tinahones, Francisco J.
A1 Lapetra, Jose
A1 Pinto, Xavier
A1 Tur, Josep A.
A1 Lopez-Miranda, Jose
A1 Bueno-Cavanillas, Aurora
A1 Gaforio, Jose J.
A1 Matia-Martin, Pilar
A1 Daimiel, Lidia
A1 Martin-Sanchez, Vicente
A1 Vidal, Josep
A1 Vazquez, Clotilde
A1 Ros, Emilio
A1 Dalsgaard, Soren
A1 Sayon-Orea, Carmen
A1 Sorli, Jose, V
A1 de la Torre, Rafael
A1 Abete, Itziar
A1 Tojal-Sierra, Lucas
A1 Baron-Lopez, Francisco J.
A1 Fernandez-Brufal, Noelia
A1 Konieczna, Jadwiga
A1 Garcia-Rios, Antonio
A1 Sacanella, Emilio
A1 Bernal-Lopez, M. Rosa
A1 Santos-Lozano, Jose M.
A1 Razquin, Cristina
A1 Alvarez-Sala, Andrea
A1 Goday, Albert
A1 Angeles Zulet, M.
A1 Vaquero-Luna, Jessica
A1 Diez-Espino, Javier
A1 Cuenca-Royo, Aida
A1 Fernandez-Aranda, Fernando
A1 Bullo, Monica
A1 Salas-Salvado, Jordi
A1 PREDIMED-Plus Investigators, 
K1 cognitive function
K1 diabetes duration
K1 glycated (glycosylated) hemoglobin
K1 insulin resistance
K1 type 2 diabetes
K1 prediabetes
K1 Physical-activity questionnaire
K1 Hypoglycemic episodes
K1 Insulin-resistance
K1 Diabetes-mellitus
K1 Glucose
K1 Decline
K1 Dementia
K1 Validation
K1 Criteria
K1 Midlife
AB IntroductionType 2 diabetes has been linked to greater cognitive decline, but other glycemic parameters such as prediabetes, diabetes control and treatment, and HOMA-IR and HbA(1c) diabetes-related biomarkers have shown inconsistent results. Furthermore, there is limited research assessing these relationships in short-term studies. Thus, we aimed to examine 2-year associations between baseline diabetes/glycemic status and changes in cognitive function in older participants at high risk of cardiovascular disease. MethodsWe conducted a 2-year prospective cohort study (n=6,874) within the framework of the PREDIMED-Plus study. The participants (with overweight/obesity and metabolic syndrome; mean age 64.9 years; 48.5% women) completed a battery of 8 cognitive tests, and a global cognitive function Z-score (GCF) was estimated. At baseline, participants were categorized by diabetes status (no-diabetes, prediabetes, and = 5-year diabetes duration), and also by diabetes control. Furthermore, insulin resistance (HOMA-IR) and glycated hemoglobin (HbA(1c)) levels were measured, and antidiabetic medications were recorded. Linear and logistic regression models, adjusted by potential confounders, were fitted to assess associations between glycemic status and changes in cognitive function. ResultsPrediabetes status was unrelated to cognitive decline. However, compared to participants without diabetes, those with >= 5-year diabetes duration had greater reductions in GCF (beta=-0.11 (95%CI -0.16;-0.06)], as well as in processing speed and executive function measurements. Inverse associations were observed between baseline HOMA-IR and changes in GCF [beta=-0.0094 (95%CI -0.0164;-0.0023)], but also between HbA(1c) levels and changes in GCF [beta=-0.0085 (95%CI -0.0115, -0.0055)], the Mini-Mental State Examination, and other executive function tests. Poor diabetes control was inversely associated with phonologic fluency. The use of insulin treatment was inversely related to cognitive function as measured by the GCF [beta=-0.31 (95%CI -0.44, -0.18)], and other cognitive tests.= 5-year diabetes duration had greater reductions in GCF (beta=-0.11 (95%CI -0.16;-0.06)], as well as in processing speed and executive function measurements. Inverse associations were observed between baseline HOMA-IR and changes in GCF [beta=-0.0094 (95%CI -0.0164;-0.0023)], but also between HbA(1c) levels and changes in GCF [beta=-0.0085 (95%CI -0.0115, -0.0055)], the Mini-Mental State Examination, and other executive function tests. Poor diabetes control was inversely associated with phonologic fluency. The use of insulin treatment was inversely related to cognitive function as measured by the GCF [beta=-0.31 (95%CI -0.44, -0.18)], and other cognitive tests. ConclusionsInsulin resistance, diabetes status, longer diabetes duration, poor glycemic control, and insulin treatment were associated with worsening cognitive function changes in the short term in a population at high cardiovascular risk.
PB Frontiers media sa
SN 1664-2392
YR 2021
FD 2021-10-29
LK https://hdl.handle.net/10668/25681
UL https://hdl.handle.net/10668/25681
LA en
DS RISalud
RD Apr 10, 2025