966-P: Glucose Control and Cognitive Function in Older Adults with Diabetes or Prediabetes: Results from the 2011-2014 National Health and Nutrition Examination Survey (NHANES)

Abstract

Objective: Poor glucose control (A1c) has been associated with cognitive impairment in adults with diabetes, but it is unknown whether people with prediabetes who have elevated A1c are also at risk. Our aims were to 1) examine the relationships between A1c and cognitive function in older adults with diabetes or prediabetes and 2) explore whether body mass index (BMI) and functional disability affect cognitive function. Method: We extracted data of adults aged ≥ 60 years with self-reported diabetes or prediabetes from the 2011-2014 NHANES database. Variables included the Digit Symbol Substitution Test (DSST) for attention and processing speed; the Animal Fluency (AF) test for semantic fluency, and the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) Word Learning subtest for delayed and immediate memory. BMI, activities of daily living (ADL), instrumental ADL (IADL), and A1c were examined. Chi-square, t-test, and multivariate linear regressions were used. Results: A total of 1,070 older adults were included (age 69.94±6.73 years, male 50.65 %, diabetes=870, prediabetes=200). Diabetes group had significantly lower scores for all cognitive assessments, higher A1c values, more ADL disability, and were more obese than prediabetes group. A 1% increase in A1c decreased DSST score by 1.24, AF by .29, and CERAD delayed memory by .17. Being underweight decreased cognitive function (DSST=-13.15, AF=-2.97), while obesity had a protective effect (DDST=3.18). Having at least one ADL or IADL disability also decreased cognitive function (DSST=-6.19; AF=-1.47, CERAD delayed=-.60, and CERAD immediate=-1.08). Conclusions: Our findings suggest that higher A1c, being underweight, and functional disability are associated with cognitive impairment, which highlights the need for regular cognitive testing in older adults with higher A1c, especially those with high BMI and reduced functional ability. Disclosure M. Kim: None. C. Fritschi: None.