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Better blood sugar (glucose) control was associated with better mental (cognitive) function and less mental decline, while worse control was associated with worse mental function and greater decline, the researchers found.
"As the population is aging, the prevalence of diabetes and stroke is increasing, and both diseases are risk factors for cognitive dysfunction and dementia," said lead author Dr. Tali Cukierman-Yaffe. She's a researcher at Sackler School of Medicine of Tel Aviv University, in Israel.
Every 1% increase in baseline hemoglobin A1C (an estimate of average glucose levels in the previous three months) was associated with a 0.06 lower standardized Cognitive Abilities Screening Instrument (CASI) score.
With a score range of 0 to 100, CASI measures attention, concentration, short- and long-term memory, language abilities and other mental skills.
Higher baseline A1C values were associated with lower cognitive scores over time, and a 1% increase in A1C over time was associated with a 0.021 decrease in CASI score during follow-up, according to the study published in a special supplemental issue of the Journal of the Endocrine Society.
Although the study could not prove a cause-and-effect relationship, the findings remained statistically significant even after the authors adjusted for such factors as age, sex, education, race, depression, high blood pressure, body mass index, heart disease, obstructive sleep apnea, insulin use and abnormalities in brain white matter.
"Identifying modifiable risk factors that are associated with cognitive dysfunction in people with type 2 diabetes who experience a lacunar stroke has major public health implications," Cukierman-Yaffe noted in an Endocrine Society news release.
"Intervention studies are needed to investigate whether tighter glucose control may slow the rate of cognitive decline in this population," she added.
-- Robert Preidt
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