Life-Course Glucose Trajectory and Cognitive Function in Middle Age—Evidence from the Bogalusa Heart Study

Abstract

Although the adverse effects of elevated glucose on cognitive function have been well-documented, most cognitive evidence comes from older adults. In this study, we make use of repeated measurements across five decades of the Bogalusa Heart Study and latent class methodology to examine the association of glucose from childhood through early adulthood on cognitive function in middle age. From our cohort of n=1,298 adults, after adjustment for age, sex, race, BMI, diabetic status, smoking, physical activity, and depressive symptoms, we identified four trajectory classes of glucose over the life course: (1) “healthy and stable;” (2) “healthy but slightly increasing;” (3) “decreasing;” and (4) “sharply increasing” (Figure). The distributions of trajectory class membership were modeled with a relative cognitive z-score, computed from a battery of tests covering major neuropsychological domains. Mean z-scores, where higher indicates better relative cognitive function, for classes 1-4 were 1.04, 0.85, 0.19, and -6.69, respectively. Parameter estimates were positive for classes 1-3, and negative for class 4 (p<0.05). The “sharply increasing” class was inversely associated with each individual cognitive test except Logical Memory II-Recognition. Our findings suggest increasing glucose trajectories may adversely affect cognition earlier in adulthood than previously thought. Disclosure P. Stuchlik: None. O. Carmichael: None. E. Harville: None. H. He: None. M. Romero: None. J. Gustat: None. V. Fonseca: Consultant; Self; Abbott. Board Member; Self; American Association of Clinical Endocrinologists. Consultant; Self; Eli Lilly and Company. Stock/Shareholder; Self; Amgen Inc.. Consultant; Self; Asahi Kasei Corporation, AstraZeneca, Novo Nordisk Inc., ADOCIA, Intarcia Therapeutics, Inc., Sanofi-Aventis. L.A. Bazzano: None.