Associations of the Glycaemic Control of Diabetes with Dementia and Physical Function in Rural-Dwelling Older Chinese Adults: A Population-Based Study.

Abstract

PurposeTo examine the associations of impaired fasting glucose (IFG) and glycaemic control of diabetes with dementia, global cognitive function and physical function among rural-dwelling Chinese older adults.Patients and MethodsThis population-based cross-sectional study included 4583 participants (age ≥65 years, 57.3% women) living in Yanlou Town, Yanggu County, western Shandong Province, China. In 2018, data were collected through interviews, clinical examinations, neuropsychological tests, and laboratory tests. Diabetes status was defined by self-reported physician-diagnosed diabetes, current use of antidiabetic agents, and fasting blood glucose tests. Global cognitive function was assessed using the Mini-Mental State Examination. Dementia was diagnosed following DSM-IV criteria, and Alzheimer’s disease (AD) was diagnosed following the National Institute on Aging-Alzheimer’s Association criteria. Physical function was assessed by the Short Physical Performance Battery. Data were analysed using multiple logistic and general linear regression models.ResultsIFG was found in 267 participants, and diabetes was diagnosed in 658 participants (257 with well-controlled diabetes, 401 with poorly controlled diabetes). Dementia was diagnosed in 166 participants (116 with AD), and physical functional impairment was found in 1973 participants. The multi-adjusted odds ratio (OR) of dementia associated with poorly controlled diabetes (vs without IFG or diabetes) was 2.41 (95% CI 1.52–3.84), and the OR of AD associated with poorly controlled diabetes was 2.32 (1.34–4.04). In addition, the adjusted OR of physical functional impairment was 1.40 (1.06–1.85) for well-controlled diabetes and 1.69 (1.35–2.12) for poorly controlled diabetes. However, IFG was not associated with cognitive or physical function.ConclusionThe glycaemic control status of diabetes patients was associated with cognitive impairment and physical functional impairment.