Siena Duarte1, Tina Hoang2, Susan K Ewing3, Peggy M Cawthon4, Steve Cummings5, Katie L Stone4, Jane A Cauley6, Douglas C Bauer5, Teresa A Hillier7,8, Kristine Yaffe2,3,9,10. 1. University of California San Francisco (UCSF), School of Medicine. 2. San Francisco Veterans Affairs Medical Center, California. 3. Department of Epidemiology and Biostatistics, University of California San Francisco (UCSF). 4. Research Institute, California Pacific Medical Center, San Francisco. 5. Department of Medicine, University of California San Francisco (UCSF). 6. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania. 7. Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon. 8. Center for Health Research, Kaiser Permanente Hawaii, Honolulu. 9. Memory and Aging Center, Department of Neurology, University of California San Francisco (UCSF). 10. Departments of Psychiatry, University of California San Francisco (UCSF).
Abstract
BACKGROUND: The association between diabetes and dementia may be explained in part by elevated levels of glycated peptides; we sought to determine whether serum-glycated peptides predicted cognitive decline in nondiabetic older adults. METHODS: We prospectively studied 525 community-dwelling nondiabetic women, mean age of 82 years, and analyzed baseline glycated peptides (serum level of fructosamine and glycated albumin). Cognitive outcomes included 5-year decline on the short Mini-Mental State Examination (sMMSE), Trails B, and performance on a battery of five other cognitive tests at the follow-up visit. Generalized linear models were adjusted for education, age, race, physical activity, body mass index, and vascular disease. RESULTS: Women with higher level of fructosamine (upper two tertiles) had greater 5-year decline in Trails B performance compared with women in the lowest tertile (adjusted mean change = 67 vs 50 seconds, p = .046), but change in sMMSE was not different between groups. Higher fructosamine was also associated with worse cognitive function 5 years later: adjusted mean score for the California Verbal Learning Test-II Short Form was 22.7 versus 23.9 (p = .010) and for Category Fluency was 10.1 versus 11.1 (p = .003). Higher glycated albumin was also associated with worse performance on Category Fluency (10.1 vs 11.1, p = .003) but not on any other test. CONCLUSIONS: Among older nondiabetic women, higher concentrations of glycated peptides may be associated with greater cognitive decline, especially in measures of executive function. These associations may present new opportunities for targeted prevention and therapeutic strategies in cognitive aging.
BACKGROUND: The association between diabetes and dementia may be explained in part by elevated levels of glycated peptides; we sought to determine whether serum-glycated peptides predicted cognitive decline in nondiabetic older adults. METHODS: We prospectively studied 525 community-dwelling nondiabeticwomen, mean age of 82 years, and analyzed baseline glycated peptides (serum level of fructosamine and glycated albumin). Cognitive outcomes included 5-year decline on the short Mini-Mental State Examination (sMMSE), Trails B, and performance on a battery of five other cognitive tests at the follow-up visit. Generalized linear models were adjusted for education, age, race, physical activity, body mass index, and vascular disease. RESULTS:Women with higher level of fructosamine (upper two tertiles) had greater 5-year decline in Trails B performance compared with women in the lowest tertile (adjusted mean change = 67 vs 50 seconds, p = .046), but change in sMMSE was not different between groups. Higher fructosamine was also associated with worse cognitive function 5 years later: adjusted mean score for the California Verbal Learning Test-II Short Form was 22.7 versus 23.9 (p = .010) and for Category Fluency was 10.1 versus 11.1 (p = .003). Higher glycated albumin was also associated with worse performance on Category Fluency (10.1 vs 11.1, p = .003) but not on any other test. CONCLUSIONS: Among older nondiabeticwomen, higher concentrations of glycated peptides may be associated with greater cognitive decline, especially in measures of executive function. These associations may present new opportunities for targeted prevention and therapeutic strategies in cognitive aging.
Authors: S R Cummings; D M Black; M C Nevitt; W S Browner; J A Cauley; H K Genant; S R Mascioli; J C Scott; D G Seeley; P Steiger Journal: JAMA Date: 1990-02-02 Impact factor: 56.272
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