Effect of poor glycemic control in cognitive performance in the elderly with type 2 diabetes mellitus: The Mexican Health and Aging Study

BackgroundCognitive impairment is twice more frequent in elderly with type 2 diabetes mellitus (DM). This study was conducted to determine the association between glycemic control and cognitive performance among community-dwelling elderly persons in Mexico.MethodsCross-sectional study conducted in individuals aged 60years or elderly participating in the 2012 Mexican Health and Aging Study. Type 2 DM participants were classified in 3 groups according to their glycated hemoglobin levels (Hb(A1c)): <7% (intensive control), 7-7.9% (standard control) or8% (poor control), and cognitive performance: low (CCCE <= 44 points), intermediate (44.1-59.52 points), or high (>= 59.53 points). Multinomial logistic regression models were constructed to determine this association.ResultsTwo hundred sixteen community-dwelling adults aged 60 and older with type 2 diabetes were selected. Subjects in the low cognitive performance group were older (69.76.6 vs 65.865.18years, p<.001) and had a lower educational level (2.52.6 vs 7.44 +/- 4.15years, p<.000) when compared to the high cognitive performance participants. Hb(A1c)8% was associated with having low (Odds Ratio (OR) 3.17, 95% CI 1.17-8.60, p=.024), and intermediate (OR 3.23, 95% CI 1.27-8.20, p=.014) cognitive performance; this trend was not found for Hb(A1c) 7.0-7.9% group.The multinomial regression analysis showed that the presence of Hb(A1c)>= 8% (poor glycemic control) was associated with low (OR 3.17, 95% CI=1.17-8.60, p=.024), and intermediate (OR 3.23, 95% CI=1.27-8.20, p=.014) cognitive performance. After adjusting for confounding variables.Conclusions Glycemic control with a Hb(A1c)>= 8% was associated with worse cognitive performance.