Visit-to-Visit Glucose Variability, Cognition, and Global Cognitive Decline: The Multi-Ethnic Study of Atherosclerosis
Authors' conclusion
Higher visit-to-visit GV over 16 to 18 years is associated with worse cognitive performance in the general population, and with modest global cognitive decline in participants with T2D.
Study context
- Population
- Racially/ethnically diverse older Multi-Ethnic Study of Atherosclerosis participants with and without T2D; glucose over 6 clinical examinations1,834 with repeat Cognitive Abilities Screening Instrument (CASI)
- Participants
- 4,367 participants
- Exposure
- Two-fold increments in visit-to-visit glucose variability
- Outcome
- Cognitive performance (CASI, Digit Symbol Coding) and decline in CASI
- Follow-up
- Cognitive assessment at fifth examination; second assessment 6 years later
Methodological detailsmulti-ethnic, multivariable linear regression adjusted for cardiovascular risk factors and mean glucose
- Multi-ethnic
- Multivariable linear regression adjusted for cardiovascular risk factors and mean glucose
Main finding
As reported in the abstract
Cognitive performance per two-fold increment in GV · fifth examination
- Two-fold increments in variability independent of the mean (VIM) and standard deviation of glucose (SDG) associated with worse CASI performance
- Two-fold increments in VIM and average real variability (ARV) associated with worse Digit Symbol Coding test score
Observational data: associations, not effects.
Further findings
Change in CASI · 6 years later
- Glucose variability (GV) measures not associated with change in CASI among participants with repeat CASI data
- 1834 participants
Decline in CASI, participants with incident T2D · 6 years later
Points
- SDG
- −1.7 (95% CI: −3.1, −0.3)
- VIM
- −2.1 (95% CI: −3.7, −0.5)
- 229 participants with incident T2D
Single-timepoint glucose and HbA1c and CASI decline
- Not associated with CASI decline among participants with or without incident T2D
Original publication
Visit-to-Visit Glucose Variability, Cognition, and Global Cognitive Decline: The Multi-Ethnic Study of Atherosclerosis. J Clin Endocrinol Metab. Published 27 July 2023. doi:10.
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