Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Oct;30(10):1093-100.
doi: 10.1002/gps.4267. Epub 2015 Feb 20.

Glycemic control, inflammation, and cognitive function in older patients with type 2 diabetes

Jimmy Akrivos  1   2 , Ramit Ravona-Springer  3 , James Schmeidler  1 , Derek LeRoith  4   5 , Anthony Heymann  6 , Rachel Preiss  6 , Hadas Hoffman  6 , Keren Koifman  3 , Jeremy M Silverman  1   2 , Michal Schnaider Beeri  1   3   7
Affiliations

Glycemic control, inflammation, and cognitive function in older patients with type 2 diabetes

Jimmy Akrivos et al. Int J Geriatr Psychiatry. 2015 Oct.

Abstract

Objective: Glycated hemoglobin (HbA1c) and C-reactive protein (CRP) have been associated with cognitive impairment independently. However, it is unclear if their combination exacerbates poor cognitive function. We assessed whether long-term glycemic level and glycemic variability modulate the association of systemic inflammation with cognitive function, in a sample of cognitively normal older people with type 2 diabetes.

Methods: A retrospective cohort study of 777 randomly selected participants from ~11,000 patients in the Maccabi Healthcare Services Diabetes Registry, as part of the Israel Diabetes and Cognitive Decline study. Subjects averaged 18 (±9.4) HbA1c measures in the Maccabi Healthcare Services Registry, which were used to calculate long-term glycemic level (HbA1c-mean) and glycemic variability (HbA1c-standard deviation (SD)). Linear regression models assessed the interactions of CRP, a marker of systemic inflammation, with HbA1c-mean and HbA1c-SD on subjects' performance in tests of Memory, Executive Functions, Attention, and Semantic Categorization.

Results: Quadratic interactions of CRP with HbA1c-SD approached significance for executive functions and overall cognition. However, after Bonferroni adjustment, none of the interactions of CRP with HbA1c were statistically significant. In partial correlations according to HbA1c-SD tertiles, CRP was weakly correlated in the middle tertile with decreased performance in the domains of semantic categorization (r = -0.166, p = 0.011), executive functions (r = -0.136, p = 0.038), and overall cognition (r = -0.157, p = 0.016).

Conclusions: Glycated hemoglobin does not substantially modulate the association of CRP with cognition in a sample of cognitively normal, community dwelling older people with relatively well-managed type 2 diabetes.

Keywords: C-reactive protein; HbA1c; cognitive function; older people; type 2 diabetes.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

None declared.

References

    1. Abbatecola AM, Rizzo MR, Barbieri M, et al. Postprandial plasma glucose excursions and cognitive functioning in aged type 2 diabetics. Neurology. 2006;67:235–40. - PubMed
    1. Akiyama H, Barger S, Barnum S, et al. Inflammation and Alzheimer’s disease. Neurobiol Aging. 2000;21:383–421. - PMC - PubMed
    1. Beeri MS, Schmeidler J, Silverman JM, et al. Insulin in combination with other diabetes medication is associated with less Alzheimer neuropathology. Neurology. 2008;71:750–7. - PMC - PubMed
    1. Beeri MS, Ravona-Springer R, Silverman JM, Haroutunian V. The effects of cardiovascular risk factors on cognitive compromise. Dialogues Clin Neurosci. 2009;11:201–12. - PMC - PubMed
    1. Ceriello A, Esposito K, Piconi L, et al. Oscillating glucose is more deleterious to endothelial function and oxidative stress than mean glucose in normal and type 2 diabetic patients. Diabetes. 2008;57:1349–54. - PubMed

Publication types