Association between Blood Glucose Control and Subjective Cognitive Decline in Korean Patients with Diabetes Aged over 50 Years
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data and Study Population
2.2. Dependent Variable
2.3. Independent Variable
2.4. Covariates
2.5. Statistical Analysis
2.6. Ethical Approval
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Nichols, E.; Szoeke, C.E.; Vollset, S.E.; Abbasi, N.; Abd-Allah, F.; Abdela, J.; Aichour, M.T.E.; Akinyemi, R.O.; Alahdab, F.; Asgedom, S.W.; et al. Global, Regional, and National Burden of Alzheimer’s Disease and Other Dementias, 1990–2016: A Systematic Analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019, 18, 88–106. [Google Scholar] [CrossRef] [Green Version]
- Knopman, D.S.; Petersen, R.C. Mild Cognitive Impairment and Mild Dementia: A Clinical Perspective. Mayo Clin. Proc. 2014, 89, 1452–1459. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Jessen, F. Subjective and Objective Cognitive Decline at the Pre-Dementia Stage of Alzheimer’s Disease. Eur. Arch. Psychiatry Clin. Neurosci. 2014, 264, 3–7. [Google Scholar] [CrossRef] [PubMed]
- Slot, R.E.; Sikkes, S.A.; Berkhof, J.; Brodaty, H.; Buckley, R.; Cavedo, E.; Dardiotis, E.; Guillo-Benarous, F.; Hampel, H.; Kochan, N.A.; et al. Subjective Cognitive Decline and Rates of Incident Alzheimer’s Disease and Non–Alzheimer’s Disease Dementia. Alzheimers Dement. 2019, 15, 465–476. [Google Scholar] [CrossRef] [PubMed]
- Yuan, X.-Y.; Wang, X.-G. Mild Cognitive Impairment in Type 2 Diabetes Mellitus and Related Risk Factors: A Review. Rev. Neurosci. 2017, 28, 715–723. [Google Scholar] [CrossRef]
- Valenza, S.; Paciaroni, L.; Paolini, S.; Bonfigli, A.R.; Di Rosa, M.; Rabini, R.A.; Tortato, E.; Pelliccioni, P.; Pelliccioni, G. Mild Cognitive Impairment Subtypes and Type 2 Diabetes in Elderly Subjects. J. Clin. Med. 2020, 9, 2055. [Google Scholar] [CrossRef]
- Zhang, X.; Jiang, X.; Han, S.; Liu, Q.; Zhou, J. Type 2 Diabetes Mellitus is Associated With the Risk of Cognitive Impairment: A Meta-Analysis. J. Mol. Neurosci. 2019, 68, 251–260. [Google Scholar] [CrossRef]
- Ma, F.; Wu, T.; Miao, R.; Zhang, W.; Huang, G. Conversion of Mild Cognitive Impairment to Dementia Among Subjects with Diabetes: A Population-Based Study of Incidence and Risk Factors With Five Years of Follow-Up. J. Alzheimers Dis. 2015, 43, 1441–1449. [Google Scholar] [CrossRef]
- Zhong, Y.; Zhang, X.Y.; Ya, M.; Zhu, J.H.; Hong, Y.; Wang, B.Y.; Jun, J.; Hu, T.J.; Jia, W.P. The Relationship Between Glucose Excursion and Cognitive Function in Aged Type 2 Diabetes Patients. Biomed. Environ. Sci. 2012, 25, 1–7. [Google Scholar] [CrossRef]
- Crane, P.K.; Walker, R.; Hubbard, R.A.; Li, G.; Nathan, D.M.; Zheng, H.; Haneuse, S.; Craft, S.; Montine, T.J.; Kahn, S.E. Glucose Levels and Risk of Dementia. N. Engl. J. Med. 2013, 369, 540–548. [Google Scholar] [CrossRef] [Green Version]
- Farris, W.; Mansourian, S.; Chang, Y.; Lindsley, L.; Eckman, E.A.; Frosch, M.P.; Eckman, C.B.; Tanzi, R.E.; Selkoe, D.J.; Guénette, S. Insulin-Degrading Enzyme Regulates the Levels of Insulin, Amyloid β-Protein, and the β-Amyloid Precursor Protein Intracellular Domain In Vivo. Proc. Natl. Acad. Sci. USA 2003, 100, 4162–4167. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Sims-Robinson, C.; Kim, B.; Rosko, A.; Feldman, E.L. How Does Diabetes Accelerate Alzheimer Disease Pathology? Nat. Rev. Neurol. 2010, 6, 551–559. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Imamine, R.; Kawamura, T.; Umemura, T.; Umegaki, H.; Kawano, N.; Hotta, M.; Kouchi, Y.; Hatsuda, S.; Watarai, A.; Kanai, A.; et al. Does Cerebral Small Vessel Disease Predict Future Decline of Cognitive Function in Elderly People With Type 2 Diabetes? Diabetes Res. Clin. Pract. 2011, 94, 91–99. [Google Scholar] [CrossRef] [PubMed]
- Umegaki, H.; Kawamura, T.; Kawano, N.; Umemura, T.; Kanai, A.; Sano, T. Factors Associated With Cognitive Decline in Elderly Diabetics. Dement. Geriatr. Cogn. Dis. Extra 2011, 1, 1–9. [Google Scholar] [CrossRef]
- Lo, R.Y.; Chen, S.-C.; Yang, Y.-L.; Wang, Y.-H.; Chen, H.-D.; Li, J.-C.; Wu, D.-A. Cognitive Impairment and Glycemic Control in Elderly Patients Under Health-Care Case Management. J. Geriatr. Psychiatry Neurol. 2018, 31, 265–270. [Google Scholar] [CrossRef] [PubMed]
- Xue, M.; Xu, W.; Ou, Y.-N.; Cao, X.-P.; Tan, M.-S.; Tan, L.; Yu, J.-T. Diabetes Mellitus and Risks of Cognitive Impairment and Dementia: A Systematic Review and Meta-Analysis of 144 Prospective Studies. Ageing Res. Rev. 2019, 55, 100944. [Google Scholar] [CrossRef]
- Taylor, C.A.; Bouldin, E.D.; McGuire, L.C. Subjective Cognitive Decline Among Adults Aged ≥ 45 years—United States, 2015–2016. MMWR Morb. Mortal. Wkly. Rep. 2018, 67, 753–757. [Google Scholar] [CrossRef]
- Ju, Y.J.; Lee, J.; Lee, S.Y. Associations Between Chewing Difficulty, Subjective Cognitive Decline, and Related Functional Difficulties Among Older People Without Dementia: Focus on Body Mass Index. J. Nutr. Health Aging 2021, 25, 347–355. [Google Scholar] [CrossRef]
- Lee, J.E.; Ju, Y.J.; Chun, K.H.; Lee, S.Y. The Frequency of Sleep Medication Use and the Risk of Subjective Cognitive Decline (SCD) or SCD With Functional Difficulties in Elderly Individuals Without Dementia. J. Gerontol. A Biol. Sci. Med. Sci. 2020, 75, 1693–1698. [Google Scholar] [CrossRef]
- Lee, H.J.; Jang, J.; Lee, S.A.; Oh, S.S.; Park, E.-C. Association Between the Type of Diabetes Treatment and Depressive Symptoms Among Patients With Diabetes: A Cross-Sectional Study of Korea Community Health Surveys Data, 2011–2016. Int. J. Environ. Res. Public Health 2019, 16, 4441. [Google Scholar] [CrossRef] [Green Version]
- Lee, S.Y.; Ju, Y.J.; Lee, J.E.; Kim, Y.T.; Hong, S.C.; Choi, Y.J.; Song, M.K.; Kim, H.Y. Factors Associated With Poor Sleep Quality in the Korean General Population: Providing Information From the Korean Version of the Pittsburgh Sleep Quality Index. J. Affect. Disord. 2020, 271, 49–58. [Google Scholar] [CrossRef] [PubMed]
- Han, C.; Jo, S.A.; Kwak, J.-H.; Pae, C.-U.; Steffens, D.; Jo, I.; Park, M.H. Validation of the Patient Health Questionnaire-9 Korean Version in the Elderly Population: The Ansan Geriatric Study. Compr. Psychiatry 2008, 49, 218–223. [Google Scholar] [CrossRef] [PubMed]
- Hosmer, D.W.; Lemeshow, S. Interpretation of the Fitted Logistic Regression Model. Appl. Logist. Logist. Regres. 2000, 2, 47–90. [Google Scholar]
- Gottesman, R.F.; Albert, M.S.; Alonso, A.; Coker, L.H.; Coresh, J.; Davis, S.M.; Deal, J.A.; McKhann, G.M.; Mosley, T.H.; Sharrett, A.R.; et al. Associations Between Midlife Vascular Risk Factors and 25-Year Incident Dementia in the Atherosclerosis Risk in Communities (ARIC) Cohort. JAMA Neurol. 2017, 74, 1246–1254. [Google Scholar] [CrossRef] [PubMed]
- Biessels, G.J.; Staekenborg, S.; Brunner, E.; Brayne, C.; Scheltens, P. Risk of Dementia in Diabetes Mellitus: A Systematic Review. Lancet Neurol. 2006, 5, 64–74. [Google Scholar] [CrossRef]
- Kirvalidze, M.; Hodkinson, A.; Storman, D.; Fairchild, T.J.; Bała, M.; Beridze, G.; Zuriaga, A.; Brudasc, N.I.; Brini, S. The Role of Glucose on Cognition, Risk of Dementia, and Related Biomarkers in Individuals Without Type 2 Diabetes Mellitus or the Metabolic Syndrome: A Systematic Review of Observational Studies. Neurosci. Biobehav. Rev. 2022, 104551. [Google Scholar] [CrossRef]
- Rodríguez-Gutiérrez, R.; Montori, V.M. Glycemic Control for Patients With Type 2 Diabetes Mellitus: Our Evolving Faith in the Face of Evidence. Circ. Cardiovasc. Qual. Outcomes 2016, 9, 504–512. [Google Scholar] [CrossRef] [Green Version]
- Ledesma, M.D.; Bonay, P.; Colaço, C.; Avila, J. Analysis of Microtubule-Associated Protein Tau Glycation in Paired Helical Filaments. J. Biol. Chem. 1994, 269, 21614–21619. [Google Scholar] [CrossRef]
- Jeong, I.-H.; Kim, J.-M.; Jang, D.-S.; Kim, J.-H.; Cho, J.-H.; Kim, J.-S. Screening of Korean Herbal Medicines With Inhibitory Activity on Advanced Glycation End Products (AGEs) Formation (III). Korean J. Pharmacogn. 2009, 40, 382–387. [Google Scholar]
- Donahue, J.E.; Flaherty, S.L.; Johanson, C.E.; Duncan, J.A.; Silverberg, G.D.; Miller, M.C.; Tavares, R.; Yang, W.; Wu, Q.; Sabo, E.; et al. RAGE, LRP-1, and Amyloid-Beta Protein in Alzheimer’s Disease. Acta Neuropathol. 2006, 112, 405–415. [Google Scholar] [CrossRef]
- Wirt, R.; Crew, L.; Ortiz, A.; McNeela, A.; Flores, E.; Kinney, J.; Hyman, J.M. Altered Theta Rhythm and Hippocampal-Cortical Interactions Underlie Working Memory Deficits in a Hyperglycemia Risk Factor Model of Alzheimer’s Disease. Commun. Biol. 2021, 4, 1–16. [Google Scholar] [CrossRef] [PubMed]
- Neth, B.J.; Craft, S. Insulin Resistance and Alzheimer’s Disease: Bioenergetic Linkages. Front. Aging Neurosci. 2017, 9, 345. [Google Scholar] [CrossRef] [PubMed]
- Kang, Y.W.; Ko, Y.S.; Kim, Y.J.; Sung, K.M.; Kim, H.J.; Choi, H.Y.; Sung, C.; Jeong, E. Korea Community Health Survey Data Profiles. Osong Public Health Res. Perspect. 2015, 6, 211–217. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Variables | Total | Blood Glucose Control | p | ||||
---|---|---|---|---|---|---|---|
Yes (n = 16,478, 87.7%) | No (n = 2311, 12.3%) | ||||||
n | % | n | % | n | % | ||
Age (years) | <0.001 | ||||||
50–59 | 3873 | 20.6 | 3307 | 85.4 | 566 | 14.6 | |
60–69 | 6560 | 34.9 | 5742 | 87.5 | 818 | 12.5 | |
70–79 | 6282 | 33.4 | 5575 | 88.7 | 707 | 11.3 | |
≥80 | 2074 | 11.1 | 1854 | 89.4 | 220 | 10.6 | |
Sex | <0.001 | ||||||
Male | 9547 | 50.3 | 8369 | 88.5 | 1088 | 11.5 | |
Female | 9332 | 49.7 | 8109 | 86.9 | 1223 | 13.1 | |
Education | <0.001 | ||||||
Uneducated | 3008 | 16.0 | 2608 | 86.7 | 400 | 13.3 | |
Elementary school | 5615 | 29.9 | 4861 | 86.6 | 754 | 13.4 | |
Middle school | 3492 | 18.6 | 3065 | 87.8 | 427 | 12.2 | |
High school | 4581 | 24.4 | 4066 | 88.8 | 515 | 11.2 | |
At least college | 2093 | 11.1 | 1878 | 89.7 | 215 | 10.3 | |
Income | <0.001 | ||||||
Low | 7800 | 41.5 | 6717 | 86.1 | 1083 | 13.9 | |
Middle–low | 5215 | 27.8 | 4596 | 88.1 | 619 | 11.9 | |
Middle–high | 3293 | 17.5 | 2942 | 89.3 | 351 | 10.7 | |
High | 2481 | 13.2 | 2223 | 89.6 | 258 | 10.4 | |
Job classification | 0.002 | ||||||
White | 1060 | 5.6 | 964 | 90.9 | 96 | 9.1 | |
Pink | 1565 | 8.3 | 1379 | 88.1 | 186 | 11.9 | |
Blue | 6186 | 32.9 | 5444 | 88.0 | 742 | 12.0 | |
Unemployed | 9978 | 53.1 | 8691 | 87.1 | 1287 | 12.9 | |
Living alone | <0.001 | ||||||
Yes | 3697 | 19.7 | 3154 | 85.3 | 543 | 14.7 | |
No | 15,092 | 80.3 | 13,324 | 88.3 | 1768 | 11.7 | |
Family composition | 0.017 | ||||||
One generation | 13,278 | 70.7 | 11,662 | 87.8 | 1616 | 12.2 | |
Two generations | 4353 | 23.2 | 3777 | 86.8 | 576 | 13.2 | |
Three generations | 1158 | 6.1 | 1039 | 89.7 | 119 | 12.3 | |
Body mass index | 0.244 | ||||||
<25.0 | 11,312 | 60.2 | 9895 | 87.5 | 1417 | 12.5 | |
≥25.0 | 7477 | 39.8 | 6583 | 88.0 | 894 | 12.0 | |
Smoking | 0.014 | ||||||
Yes | 2740 | 14.6 | 2364 | 86.3 | 376 | 13.7 | |
No | 16,049 | 85.4 | 14,114 | 87.9 | 1935 | 12.1 | |
High-risk drinking | 0.003 | ||||||
Yes | 1840 | 9.8 | 1574 | 85.5 | 266 | 14.5 | |
No | 16,949 | 90.2 | 14,904 | 87.9 | 2045 | 12.1 | |
Participation in regular walking | <0.001 | ||||||
Yes | 8292 | 44.1 | 7416 | 89.4 | 876 | 10.6 | |
No | 10,497 | 55.9 | 9062 | 86.3 | 1435 | 13.7 | |
Hypertension diagnosis | 0.004 | ||||||
Yes | 12,296 | 65.4 | 10,846 | 88.2 | 1450 | 11.8 | |
No | 6493 | 34.6 | 5632 | 86.7 | 861 | 13.3 | |
Subjective health status | <0.001 | ||||||
Good | 2946 | 15.7 | 2752 | 93.4 | 194 | 6.6 | |
Bad | 15,843 | 84.3 | 13,726 | 86.6 | 2117 | 13.4 | |
Perceived stress | <0.001 | ||||||
Yes | 4135 | 22.0 | 3242 | 82.8 | 711 | 17.2 | |
No | 14,654 | 78.0 | 13,054 | 89.1 | 1600 | 10.9 | |
Depressive symptoms (PHQ-9 score) | <0.001 | ||||||
Yes (≥10) | 1102 | 5.9 | 815 | 74.0 | 287 | 26.0 | |
No (<10) | 17,687 | 94.1 | 15,663 | 88.6 | 2024 | 11.4 | |
Sleep quality (PSQI score) | <0.001 | ||||||
Good (≤5) | 9682 | 51.5 | 8790 | 90.8 | 892 | 9.2 | |
Poor (>5) | 9107 | 48.5 | 7688 | 84.4 | 1419 | 15.6 |
Total | Subjective Cognitive Decline | p | |||||
---|---|---|---|---|---|---|---|
No (n = 13,580, 72.3%) | Yes (n = 5209, 27.7%) | ||||||
n | % | n | % | n | % | ||
Blood glucose control | <0.001 | ||||||
Controlled group | 16,478 | 87.7 | 12,066 | 73.2 | 4412 | 26.8 | |
Uncontrolled group | 2311 | 12.3 | 1514 | 65.5 | 797 | 34.5 |
Variables | Subjective Cognitive Decline | ||
---|---|---|---|
Adjusted OR 1 | 95% CI | ||
Blood glucose control | |||
Controlled group | 1.00. | ||
Uncontrolled group | 1.22 | 1.10 | 1.34 |
Age (years) | |||
50–59 | 1.00 | ||
60–69 | 1.30 | 1.17 | 1.45 |
70–79 | 1.81 | 1.61 | 2.04 |
≥80 | 2.27 | 1.96 | 2.63 |
Sex | |||
Male | 1.00 | ||
Female | 1.06 | 0.97 | 1.15 |
Education | |||
Uneducated | 1.00 | ||
Elementary school | 1.11 | 0.92 | 1.13 |
Middle school | 0.97 | 0.86 | 1.09 |
High school | 0.89 | 0.78 | 1.00 |
At least college | 0.98 | 0.84 | 1.14 |
Income | |||
Low | 1.00 | ||
Middle–low | 1.04 | 0.95 | 1.13 |
Middle–high | 0.98 | 0.88 | 1.10 |
High | 0.97 | 0.84 | 1.11 |
Job classification | |||
White | 1.00 | ||
Pink | 1.30 | 1.04 | 1.62 |
Blue | 1.36 | 1.12 | 1.66 |
Unemployed | 1.44 | 1.19 | 1.76 |
Living alone | |||
Yes | 1.00 | ||
No | 0.96 | 0.88 | 1.06 |
Family composition | |||
One generation | 1.00 | ||
Two generations | 1.05 | 0.96 | 1.15 |
Three generations | 1.19 | 1.02 | 1.38 |
Body mass index | |||
<25.0 | 1.00 | ||
≥25.0 | 0.96 | 0.90 | 1.03 |
Smoking | |||
Yes | 1.00 | ||
No | 1.09 | 0.98 | 1.22 |
High-risk drinking | |||
Yes | 1.00 | ||
No | 0.95 | 0.83 | 1.08 |
Participation in regular walking | |||
Yes | 1.00 | ||
No | 1.03 | 0.96 | 1.10 |
Hypertension diagnosis | |||
Yes | 1.00 | ||
No | 1.03 | 0.95 | 1.10 |
Subjective health status | |||
Good | 1.00 | ||
Bad | 1.53 | 1.38 | 1.70 |
Perceived stress | |||
Yes | 1.00 | ||
No | 0.75 | 0.70 | 0.82 |
Depressive symptoms (PHQ-9 score) | |||
Yes (≥10) | 1.00 | ||
No (<10) | 0.38 | 0.33 | 0.44 |
Sleep quality (PSQI score) | |||
Good (≤5) | 1.00 | ||
Poor (>5) | 1.62 | 1.51 | 1.73 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Koh, D.-H.; Rho, Y.-J.; Lee, S.Y.; Kim, K.-N.; Ju, Y.J. Association between Blood Glucose Control and Subjective Cognitive Decline in Korean Patients with Diabetes Aged over 50 Years. Int. J. Environ. Res. Public Health 2022, 19, 7267. https://doi.org/10.3390/ijerph19127267
Koh D-H, Rho Y-J, Lee SY, Kim K-N, Ju YJ. Association between Blood Glucose Control and Subjective Cognitive Decline in Korean Patients with Diabetes Aged over 50 Years. International Journal of Environmental Research and Public Health. 2022; 19(12):7267. https://doi.org/10.3390/ijerph19127267
Chicago/Turabian StyleKoh, Dae-Hyung, Yu-Jin Rho, Soon Young Lee, Kyoung-Nam Kim, and Yeong Jun Ju. 2022. "Association between Blood Glucose Control and Subjective Cognitive Decline in Korean Patients with Diabetes Aged over 50 Years" International Journal of Environmental Research and Public Health 19, no. 12: 7267. https://doi.org/10.3390/ijerph19127267