Glycemic control, cognitive aging and impairment among diverse Hispanics/Latinos: Study of Latinos-Investigation of Neurocognitive Aging (HCHS/SOL)

Abstract

<p dir="ltr"><b>Objective</b>: Hispanics/Latinos in the United States have the highest prevalence of undiagnosed and untreated diabetes and are at increased risk for cognitive impairment. In this study, we examine glycemic control<i> </i>in relation to cognitive aging and impairment in a large prospective cohort of middle-aged and older Hispanics/Latinos of diverse heritages.</p><p dir="ltr"><b>Research Design and Methods:</b><b> </b><i>Study of Latinos-Investigation of Neurocognitive Aging</i> (<b>SOL-INCA</b>) is a <i>Hispanic Community Health Study/Study of Latinos</i> (<b>HCHS/SOL</b>) ancillary study. HCHS/SOL is a multisite (Bronx, NY, Chicago, IL, Miami, FL, San Diego, CA), probability sampled prospective cohort study<b>. </b>SOL-INCA enrolled 6,377 diverse Hispanics/Latinos ages 50-years and older (2016-2018). The primary outcomes were cognitive function, 7-year cognitive decline and Mild Cognitive Impairment (MCI). The primary glycemia exposure variables were measured from fasting blood samples collected at HCHS/SOL Visit 1 (2008-2011).</p><p dir="ltr"><b>Results: </b>Visit 1 mean age was 56.5-years ±8.2 SD, and the average glycosylated hemoglobin A1C (HbA1c) was 6.12% (43.5±14.6 mmol/mol). After covariates adjustment, higher HbA1c was associated with accelerated 7-year global (b=-0.045; 95% CI=-0.070;-0.021; in z-score units) and executive cognitive decline, and a higher prevalence of MCI (OR=1.20; 95% CI=1.11;1.29).</p><p dir="ltr"><b>Conclusions:</b> Elevated HbA1c levels were associated with 7-year executive cognitive decline and increased MCI risk among diverse middle-aged and older Hispanics/Latinos. Our findings indicate poor glycemic control in midlife may pose significant risks for cognitive decline and MCI later in life among Hispanics/Latinos of diverse heritages.</p>