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Journal of the American Geriatrics Society v.65 no.1, 2017년, pp.137 - 145   SCI SCIE SSCI
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Effects of Longitudinal Glucose Exposure on Cognitive and Physical Function: Results from the Action for Health in Diabetes Movement and Memory Study

Beavers, Kristen M. (Department of Biostatistical Sciences, Wake Forest University, Winston‐ ); Leng, Iris (Salem, North Carolina ); Rapp, Stephen R. ( Department of Psychiatry and Behavioral Medicine, Wake Forest University, Winston‐ ); Miller, Michael E. (Salem, North Carolina ); Houston, Denise K. ( Department of Biostatistical Sciences, Wake Forest University, Winston‐ ); Marsh, Anthony P. (Salem, North Carolina ); Hire, Don G. ( Department of Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, School of Medicine, Wake Forest University, Winston‐ ); Baker, Laura D. (Salem, North Carolina ); Bray, George A. ( Department of Health and Exercise Science, Wake Forest University, Winston‐ ); Blackburn, George L. (Salem, North Carolina ); Hergenroeder, Andrea L. ( Department of Biostatistical Sciences, Wake Forest University, Winston‐ ); Jakicic, John M. (Salem, North Carolina ); Johnson, Karen C. ( Department of Psychiatry and Behavioral Medicine, Wake Forest University, Winston‐ ); Korytkowski, Mary T. (Salem, North Carolina ); Dorsten, Brent Van ( Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana ); Kritchevsky, Stephen B. ( Division of Nutrition, Harvard Medical School and Beth Israel Deaconess Medical Center, Bosto );
  • 초록  

    Objectives To test whether average long‐term glucose exposure is associated with cognitive and physical function in middle‐aged and younger‐old adults with type 2 diabetes mellitus. Design Prospective cohort study. Setting Data obtained as part of the Action for Health in Diabetes (Look AHEAD) trial (NCT00017953) and Look AHEAD Movement and Memory ancillary study (NCT01410097). Participants Overweight and obese individuals with type 2 diabetes mellitus aged 45 to 76 at baseline (N = 879). Measurements Glycosylated hemoglobin (HbA1c) was measured at regular intervals over 7 years, and objective measures of cognitive function (Trail‐Making Test, Modified Stroop Color‐Word Test, Digit Symbol‐Coding, Rey Auditory Verbal Learning Test, Modified Mini‐Mental State Examination) and physical function (Short Physical Performance Battery, expanded Physical Performance Battery, 400‐m and 20‐m gait speed) and strength (grip and knee extensor strength) were assessed at the Year 8 or 9 follow‐up examination. Results Average HbA1c exposure was 7.0 ± 1.1% (53 ± 11.6 mmol/mol), with 57% of participants classified as having HbA1c levels of less than 7% ( 64 mmol/mol). After adjustment for age, sex, race, education, smoking status, alcohol intake, knee pain, physical fitness, body mass index, diabetes mellitus medication and statin use, ancillary year visit, and study arm and site, higher HbA1c was associated with worse physical but not cognitive function. Further adjustment for prevalent diabetes mellitus–related comorbidities made all associations nonsignificant. Results did not differ when stratified according to participant baseline age ( Conclusion Results presented here suggest that, in the absence of diabetes mellitus–related complications, longitudinal glucose exposure is not associated with future cognitive and physical function. Optimal management of diabetes mellitus–related comorbidities may prevent or reduce the burden of disability associated with type 2 diabetes mellitus.


  • 주제어

    HbA1c .   cognition .   physical function .   type 2 diabetes mellitus.  

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