Jenni Lehtisalo1,2, Jaana Lindström1, Tiia Ngandu1, Miia Kivipelto1,3,4, Satu Ahtiluoto1,5, Pirjo Ilanne-Parikka6,7, Sirkka Keinänen-Kiukaanniemi8,9, Johan G Eriksson1,10,11,12, Matti Uusitupa13,14, Jaakko Tuomilehto15,16,17, Jose A Luchsinger18. 1. Department of Health, National Institute for Health and Welfare, Helsinki, Finland. 2. Department of Public Health, University of Helsinki, Finland. 3. Aging Research Center, Karolinska Institutet, Stockholm, Sweden. 4. Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland. 5. Espoo City Hospital, Espoo, Finland. 6. Science Center, Tampere University Hospital, Tampere, Finland. 7. The Diabetes Center, Finnish Diabetes Association, Tampere, Finland. 8. Institute of Health Sciences (General Practice), University of Oulu, Oulu, Finland. 9. Unit of General Practice, Oulu University Hospital and Health Centre of Oulu, Oulu, Finland. 10. Department of General Practice and Primary Health Care, University of Helsinki, Finland. 11. Folkhälsan Research Center, Helsinki, Finland. 12. Unit of General Practice, Helsinki University Central Hospital, Helsinki, Finland. 13. Institute of Public Health and Clinical Nutrition, Clinical Nutrition, University of Eastern Finland, Kuopio, Finland. 14. Research Unit, Kuopio University Hospital, Kuopio, Finland. 15. Center for Vascular Prevention, Danube University Krems, Krems, Austria. 16. Instituto de Investigacion Sanitaria del Hospital Universario LaPaz (IdiPAZ), Madrid, Spain. 17. Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia. 18. Department of Medicine, Columbia University Medical Center, NY, USA.
Abstract
BACKGROUND: Type 2 diabetes is linked with cognitive dysfunction and dementia in epidemiological studies, but these observations are limited by lack of data on the exact timing of diabetes onset. We investigated diabetes, dysglycaemia, and cognition in the Finnish Diabetes Prevention Study, in which the timing and duration of diabetes are well documented. METHODS: The Finnish Diabetes Prevention Study comprised middle-aged, overweight participants with impaired glucose tolerance but no diabetes at baseline (n = 522), randomized to lifestyle intervention or a control group. After an intervention period (mean duration 4 years) and follow-up (additional 9 years), cognitive assessment with the CERAD test battery and Trail Making Test A (TMT) was executed twice within a 2-year interval. Of the 364 (70%) participants with cognitive assessments, 171 (47%) had developed diabetes. RESULTS:Cognitive function did not differ between those who developed diabetes and those who did not. Lower mean 2-h glucose at an oral glucose tolerance test (OGTT) and HbA1C during the intervention period predicted better performance in the TMT (p = 0.012 and 0.024, respectively). Those without diabetes or with short duration of diabetes improved in CERAD total score between the two assessments (p = 0.001) whereas those with long duration of diabetes did not (p = 0.844). CONCLUSIONS: Better glycemic control among persons with baseline impaired glucose tolerance predicted better cognitive performance 9 years later in this secondary analysis of the Finnish Diabetes Prevention Study population. In addition, learning effects in cognitive testing were not evident in people with long diabetes duration.
RCT Entities:
BACKGROUND: Type 2 diabetes is linked with cognitive dysfunction and dementia in epidemiological studies, but these observations are limited by lack of data on the exact timing of diabetes onset. We investigated diabetes, dysglycaemia, and cognition in the Finnish Diabetes Prevention Study, in which the timing and duration of diabetes are well documented. METHODS: The Finnish Diabetes Prevention Study comprised middle-aged, overweight participants with impaired glucose tolerance but no diabetes at baseline (n = 522), randomized to lifestyle intervention or a control group. After an intervention period (mean duration 4 years) and follow-up (additional 9 years), cognitive assessment with the CERAD test battery and Trail Making Test A (TMT) was executed twice within a 2-year interval. Of the 364 (70%) participants with cognitive assessments, 171 (47%) had developed diabetes. RESULTS: Cognitive function did not differ between those who developed diabetes and those who did not. Lower mean 2-h glucose at an oral glucose tolerance test (OGTT) and HbA1C during the intervention period predicted better performance in the TMT (p = 0.012 and 0.024, respectively). Those without diabetes or with short duration of diabetes improved in CERAD total score between the two assessments (p = 0.001) whereas those with long duration of diabetes did not (p = 0.844). CONCLUSIONS: Better glycemic control among persons with baseline impaired glucose tolerance predicted better cognitive performance 9 years later in this secondary analysis of the Finnish Diabetes Prevention Study population. In addition, learning effects in cognitive testing were not evident in people with long diabetes duration.
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