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Glycemic control, cognitive aging and impairment among diverse Hispanics/Latinos: Study of Latinos-Investigation of Neurocognitive Aging (HCHS/SOL)

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posted on 2024-04-30, 02:52 authored by Hector M. González, Wassim Tarraf, Ariana M. Stickel, Alejandra Morlett, Kevin A. González, Alberto R. Ramos, Tatjana Rundek, Linda C. Gallo, Gregory A. Talavera, Martha L. Daviglus, Richard B. Lipton, Carmen Isasi, Melissa Lamar, Donglin Zeng, Charles DeCarli

Objective: Hispanics/Latinos in the United States have the highest prevalence of undiagnosed and untreated diabetes and are at increased risk for cognitive impairment. In this study, we examine glycemic control in relation to cognitive aging and impairment in a large prospective cohort of middle-aged and older Hispanics/Latinos of diverse heritages.

Research Design and Methods: Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) is a Hispanic Community Health Study/Study of Latinos (HCHS/SOL) ancillary study. HCHS/SOL is a multisite (Bronx, NY, Chicago, IL, Miami, FL, San Diego, CA), probability sampled prospective cohort study. SOL-INCA enrolled 6,377 diverse Hispanics/Latinos ages 50-years and older (2016-2018). The primary outcomes were cognitive function, 7-year cognitive decline and Mild Cognitive Impairment (MCI). The primary glycemia exposure variables were measured from fasting blood samples collected at HCHS/SOL Visit 1 (2008-2011).

Results: Visit 1 mean age was 56.5-years ±8.2 SD, and the average glycosylated hemoglobin A1C (HbA1c) was 6.12% (43.5±14.6 mmol/mol). After covariates adjustment, higher HbA1c was associated with accelerated 7-year global (b=-0.045; 95% CI=-0.070;-0.021; in z-score units) and executive cognitive decline, and a higher prevalence of MCI (OR=1.20; 95% CI=1.11;1.29).

Conclusions: Elevated HbA1c levels were associated with 7-year executive cognitive decline and increased MCI risk among diverse middle-aged and older Hispanics/Latinos. Our findings indicate poor glycemic control in midlife may pose significant risks for cognitive decline and MCI later in life among Hispanics/Latinos of diverse heritages.

Funding

This work is support by National Institute on Aging (R01AG075758, R56AG048642, RF1AG054548, RF1AG061022, R01AG075758). Dr. González also receives additional support from P30AG062429). Dr. Lamar was supported by R01AG062711. Dr. Stickel was supported by the National Institute on Aging (K08AG075351, L30AG074401) and National Cancer Institute (U54CA267789). The Hispanic Community Health Study/Study of Latinos is a collaborative study supported by contracts from the National Heart, Lung, and Blood Institute (NHLBI) to the University of North Carolina (HHSN268201300001I/N01-HC-65233), University of Miami (HHSN268201300004I/N01-HC-65234), Albert Einstein College of Medicine (HHSN268201300002I/N01-HC-65235), University of Illinois at Chicago (HHSN268201300003I/ N01- HC-65236 Northwestern Univ), and San Diego State University (HHSN268201300005I/ N01-HC-65237). The following Institutes/Centers/Offices have contributed to the HCHS/SOL through a transfer of funds to the NHLBI: National Institute on Minority Health and Health Disparities, National Institute on Deafness and Other Communication Disorders, National Institute of Dental and Craniofacial Research, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Neurological Disorders and Stroke, NIH Institution-Office of Dietary Supplements.

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