Impact of type 2 diabetes and glycated hemoglobin levels within the recommended target range on mortality in older adults with cognitive impairment receiving care at a memory clinic: NCGG-STORIES

Ayane Komatsu,Haruhiko Tokuda,Kazuaki Uchida,Kosuke Fujita,Nanae Matsumoto,Paul K Crane,Rei Ono,Taiji Noguchi,Taiki Sugimoto,Takashi Sakurai,Takeshi Nakagawa,Takuya Omura,Tami Saito,Yujiro Kuroda

doi:10.2337/figshare.25267102

Abstract

Objective: To determine the <a href="" target="_blank">impact of type 2 diabetes and glycated hemoglobin (HbA1c) levels within the recommended target range </a>according to the Japan Diabetes Society/Japan Geriatrics Society Joint Committee on mortality in older adults with cognitive impairment.Research Design and Methods:<a href="" target="_blank"> This retrospective cohort study</a> included 1,528 and 468 patients aged ≥65 years without and with type 2 diabetes, respectively, who were visiting a memory clinic. <a href="" target="_blank">The 468 patients with type 2 diabetes were divided into three groups (within/above/below the target range) based on their HbA1c levels, cognitive function, ability to perform activities of daily living, and medications associated with a high risk of hypoglycemia</a>. The impact of diabetes and HbA1c levels on mortality was evaluated using Cox proportional hazard models.Results: Over a median follow-up period of 3.8 years, 353 patients (17.7%) died. Compared with individuals without type 2 diabetes, HbA1c levels above (hazard ratio [HR] = 1.70, 95% confidence interval [CI] = 1.08–2.69) and below (HR = 2.15, 95% CI = 1.33–3.48) the target range were associated with a higher risk of death; however, HbA1c levels within the target range were not (HR = 1.02, 95% CI = 0.77–1.36).Conclusions: <a href="" target="_blank">HbA1c levels above and below the target range were </a>associated with a higher risk of mortality, whereas patients with HbA1c levels within the target range did not exhibit a higher risk of mortality than individuals without type 2 diabetes. These results provide empirical support for the current target ranges among older adults with cognitive impairment.

Full Text