Association of Glycemia, Lipids, and Blood Pressure With Cognitive Performance in People With Type 2 Diabetes in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study

Abstract

Objective: Type 2 diabetes is a risk factor for cognitive impairment. We examined the relation of glycemia, lipids, blood pressure (BP), hypertension history, and statin use with cognition in the Glycemia Reduction Approaches in Diabetes: a comparative effectiveness study (GRADE). <p>Research Design and Methods: Cross-sectional analyses from GRADE at baseline examined the association of glycemia (hemoglobin A1c [HbA1c]), LDL, systolic (SBP) and diastolic (DBP) BP, hypertension history, and statin use with cognition assessed by the Spanish English Verbal Learning Test (SEVLT), letter (LF) and animal fluency (AF) tests, and Digit Symbol Substitution Test (DSST). </p> <p>Results: Among 5,047 GRADE participants, 5,018 (99.4)% completed cognitive assessments. Their mean age was 56.7 ± 10.0 years, 36.4% were women. Mean diabetes duration was 4.0 ± 2.7 years. HbA1c was not related to cognition. Higher LDL was related to modestly worse DSST scores whereas statin use was related to modestly better DSST scores. SBP between 120 and 139 mmHg and DBP between 80 and 89 mmHg were related to modeslty better DSST scores. Hypertension history was not related to cognition. </p> <p>Conclusions: In persons with type 2 diabetes with a mean duration of less than 5 years, lower LDL and statin use were related to modestly better executive cognitive function. SBP levels in the range of 120 to 139 mmHg, and DBP levels in the range of 80 to 89 mmHg, but not lower levels, were related to modeslty better executive function. These differences may not be clinically significant. </p> <p> </p>