Linking glycemic control and executive function in rural older adults with diabetes mellitus.
OBJECTIVE
To examine the association between glycemic control and the executive functioning domain of cognition and to identify risk factors for inadequate glycemic control that may explain this relationship.


METHODS
Cross-sectional study.


METHODS
In-person interviews conducted in participants' homes.


METHODS
Ninety-five rural older African Americans, American Indians, and whites with diabetes mellitus (DM) from three counties in south-central North Carolina.


METHODS
Participants underwent uniform evaluations. Glycemic control was measured using a validated method, and executive function was assessed using a previously established set of measures and scoring procedure. Information pertaining to medication for treatment of DM, knowledge of DM, and DM self-care behaviors were obtained.


RESULTS
In linear regression models adjusting for sex, age, education, ethnicity, duration of DM, and depressive symptoms, executive function was significantly associated with glycemic control. A 1-point higher executive function score was associated with a 0.47 lower glycosylated hemoglobin value (P=.01). The association between glycemic control and executive function became nonsignificant (P=.08) when controlling for several glycemic control risk factors, including use of DM medication and DM knowledge.


CONCLUSIONS
These results suggest that poor glycemic control is associated with impairments in performance on composite measures of executive function and that modifiable risk factors for glycemic control such as use of DM medication and DM knowledge may explain this relationship.
Nguyen
Ha T
HT
Department of Family and Community Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. hnguyen@wfubmc.edu
Grzywacz
Joseph G
JG
Arcury
Thomas A
TA
Chapman
Christine
C
Kirk
Julienne K
JK
Ip
Edward H
EH
Bell
Ronny A
RA
Quandt
Sara A
SA
D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000517:prevention & control* / Q000523:psychology*; D056344:Executive Function; D005260:Female; D015577:Geriatric Assessment; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007407:Interviews as Topic; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D012307:Risk Factors
D001786:Blood Glucose; D006442:Glycated Hemoglobin