title: Glycaemia is associated with cognitive impairment in older adults: the Guangzhou Biobank Cohort Study.
abstract: OBJECTIVE
  an association between T2DM and cognitive impairment has been reported among Western populations, but data are limited in other settings. We investigated the cross-sectional association between fasting blood glucose (FBG) and cognition in an older Chinese population.
  
  
  METHODS
  the Guangzhou Biobank Cohort Study included 27,971 individuals (50-96 years, mean age 61.5 years, 72% female) with measures of cognitive function assessed using modified Delayed Word Recall Test (DWRT) and Mini-Mental State Examination (MMSE). Fasting glucose and lipids, and potential confounders were measured.
  
  
  RESULTS
  after adjustment for potential confounders, the risk for cognitive impairment as measured by DWRT, significantly increased [odds ratio (OR) = 1.18, 95% CI 1.00-1.40] but the association was of borderline significance when measured by MMSE (OR = 1.04, 95% CI 0.73-1.47) in those with diabetes relative to those without diabetes. Fasting blood glucose was significantly negatively associated with cognitive function as measured by DWRT but not MMSE, with an increase of 1 mmol/l of FBG associated with a decrease of 0.02 in DWRT (P < 0.05, 95% CI -0.03 to -0.002) and 0.03 in MMSE score (P = 0.114, 95% CI -0.06-0.01).
  
  
  CONCLUSIONS
  an FBG level indicative of T2DM was associated with increased risk for cognitive impairment. The findings also demonstrate that glycaemia is continuously associated with cognitive impairment, suggesting that dysfunction is associated with increasing glucose levels even in the normoglycaemic range.
authors.affiliation: Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK Birmingham and Black Country NIHR CLAHRC, Birmingham, UK.
authors.forename: A C
authors.initials: AC
authors.lastname: Jagielski
authors.affiliation: Guangzhou Number 12 People's Hospital, Guangzhou, China.
authors.forename: C Q
authors.initials: CQ
authors.lastname: Jiang
authors.affiliation: School of Public Health, The University of Hong Kong, Hong Kong, China.
authors.forename: L
authors.initials: L
authors.lastname: Xu
authors.affiliation: Birmingham and Black Country NIHR CLAHRC, Birmingham, UK Department of Medicine, Weill Cornell Medical College in New Youk, NY, USA Department of Medicine, Weill Cornell Medical College in Qatar, Doha, Qatar Department of Medicine, King's College London, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Taheri
authors.affiliation: Guangzhou Number 12 People's Hospital, Guangzhou, China.
authors.forename: W S
authors.initials: WS
authors.lastname: Zhang
authors.affiliation: Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK.
authors.forename: K K
authors.initials: KK
authors.lastname: Cheng
authors.affiliation: School of Public Health, The University of Hong Kong, Hong Kong, China.
authors.forename: T H
authors.initials: TH
authors.lastname: Lam
authors.affiliation: Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK Mannheim Medical Faculty, Institute of Public Health, Social and Preventive Medicine, University of Heidelberg, Mannheim 68135, Germany.
authors.forename: G N
authors.initials: GN
authors.lastname: Thomas
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood / Q000523:psychology; D000704:Analysis of Variance; D018070:Biological Specimen Banks; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis*; D002681:China; D003071:Cognition; D003072:Cognition Disorders / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D001786:Blood Glucose
keywords: cognition; glycaemia; older adult; type 2 diabetes mellitus