Associations of hemoglobin A1c with cognition reduced for long diabetes duration

Abstract Introduction Associations of some risk factors with poor cognition, identified prior to age 75, are reduced or reversed in very old age. The Protected Survivor Model predicts this interaction due to enhanced survival of those with extended risk factor duration. In a younger sample, this stu...

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Main Authors: Jeremy M. Silverman, James Schmeidler, Pearl G. Lee, Neil B. Alexander, Michal Schnaider Beeri, Elizabeth Guerrero‐Berroa, Rebecca K. West, Mary Sano, Martina Nabozny, Carolina Rodriguez Alvarez
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Alzheimer’s & Dementia: Translational Research & Clinical Interventions
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Online Access:https://doi.org/10.1016/j.trci.2019.11.009
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author Jeremy M. Silverman
James Schmeidler
Pearl G. Lee
Neil B. Alexander
Michal Schnaider Beeri
Elizabeth Guerrero‐Berroa
Rebecca K. West
Mary Sano
Martina Nabozny
Carolina Rodriguez Alvarez
author_facet Jeremy M. Silverman
James Schmeidler
Pearl G. Lee
Neil B. Alexander
Michal Schnaider Beeri
Elizabeth Guerrero‐Berroa
Rebecca K. West
Mary Sano
Martina Nabozny
Carolina Rodriguez Alvarez
author_sort Jeremy M. Silverman
collection DOAJ
description Abstract Introduction Associations of some risk factors with poor cognition, identified prior to age 75, are reduced or reversed in very old age. The Protected Survivor Model predicts this interaction due to enhanced survival of those with extended risk factor duration. In a younger sample, this study examines the association of cognition with the mean hemoglobin A1c risk factor over the time at risk, according to its duration. Methods The interaction of mean hemoglobin A1c (average = 9.8%), evaluated over duration (average = 116.8 months), was examined for overall cognition and three cognitive domains in a sample of 150 “young‐old” veterans (mean age = 70) with type 2 diabetes. Results The predicted interactions were significant for overall cognition and attention, but not executive functions/language and memory. Discussion Findings extend the Protected Survivor Model to a “young‐old” sample, from the very old. This model suggests focusing on individuals with good cognition despite prolonged high risk when seeking protective factors.
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series Alzheimer’s & Dementia: Translational Research & Clinical Interventions
spelling doaj-art-fb133743a3fd40a0bc9a2d47171b0a962025-08-20T03:22:00ZengWileyAlzheimer’s & Dementia: Translational Research & Clinical Interventions2352-87372019-01-015192693210.1016/j.trci.2019.11.009Associations of hemoglobin A1c with cognition reduced for long diabetes durationJeremy M. Silverman0James Schmeidler1Pearl G. Lee2Neil B. Alexander3Michal Schnaider Beeri4Elizabeth Guerrero‐Berroa5Rebecca K. West6Mary Sano7Martina Nabozny8Carolina Rodriguez Alvarez9Research & DevelopmentJames J. Peters Veterans Affairs Medical CenterBronxNYUSADepartment of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNYUSADepartment of Internal Medicine and Division of Geriatric and Palliative MedicineUniversity of MichiganAnn ArborMIUSADepartment of Internal Medicine and Division of Geriatric and Palliative MedicineUniversity of MichiganAnn ArborMIUSADepartment of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNYUSADepartment of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNYUSADepartment of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNYUSAResearch & DevelopmentJames J. Peters Veterans Affairs Medical CenterBronxNYUSADepartment of Internal Medicine and Division of Geriatric and Palliative MedicineUniversity of MichiganAnn ArborMIUSADepartment of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNYUSAAbstract Introduction Associations of some risk factors with poor cognition, identified prior to age 75, are reduced or reversed in very old age. The Protected Survivor Model predicts this interaction due to enhanced survival of those with extended risk factor duration. In a younger sample, this study examines the association of cognition with the mean hemoglobin A1c risk factor over the time at risk, according to its duration. Methods The interaction of mean hemoglobin A1c (average = 9.8%), evaluated over duration (average = 116.8 months), was examined for overall cognition and three cognitive domains in a sample of 150 “young‐old” veterans (mean age = 70) with type 2 diabetes. Results The predicted interactions were significant for overall cognition and attention, but not executive functions/language and memory. Discussion Findings extend the Protected Survivor Model to a “young‐old” sample, from the very old. This model suggests focusing on individuals with good cognition despite prolonged high risk when seeking protective factors.https://doi.org/10.1016/j.trci.2019.11.009Type 2 diabetesDiabetes durationHemoglobin A1cCognitive functionRisk factorsProtective factors
spellingShingle Jeremy M. Silverman
James Schmeidler
Pearl G. Lee
Neil B. Alexander
Michal Schnaider Beeri
Elizabeth Guerrero‐Berroa
Rebecca K. West
Mary Sano
Martina Nabozny
Carolina Rodriguez Alvarez
Associations of hemoglobin A1c with cognition reduced for long diabetes duration
Alzheimer’s & Dementia: Translational Research & Clinical Interventions
Type 2 diabetes
Diabetes duration
Hemoglobin A1c
Cognitive function
Risk factors
Protective factors
title Associations of hemoglobin A1c with cognition reduced for long diabetes duration
title_full Associations of hemoglobin A1c with cognition reduced for long diabetes duration
title_fullStr Associations of hemoglobin A1c with cognition reduced for long diabetes duration
title_full_unstemmed Associations of hemoglobin A1c with cognition reduced for long diabetes duration
title_short Associations of hemoglobin A1c with cognition reduced for long diabetes duration
title_sort associations of hemoglobin a1c with cognition reduced for long diabetes duration
topic Type 2 diabetes
Diabetes duration
Hemoglobin A1c
Cognitive function
Risk factors
Protective factors
url https://doi.org/10.1016/j.trci.2019.11.009
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