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Article: Higher dementia incidence in older adults with type 2 diabetes and large reduction in HbA1c

TitleHigher dementia incidence in older adults with type 2 diabetes and large reduction in HbA1c
Authors
Keywordsdementia
glycemic changes
older adults
type 2 diabetes
Issue Date2019
PublisherOxford University Press. The Journal's web site is located at http://ageing.oxfordjournals.org/
Citation
Age and Ageing, 2019, v. 48 n. 6, p. 838-844 How to Cite?
AbstractBackground: although type 2 diabetes increases risk of dementia by 2-fold, whether optimizing glycemic level in late life can reduce risk of dementia remains uncertain. We examined if achieving the glycemic goal recommended by the American Diabetes Association (ADA) within a year was associated with lower risk of dementia in 6 years. Methods; in this population-based observational study, we examined 2246 community-living dementia-free Chinese older adults with type 2 diabetes who attended the Elderly Health Centres in Hong Kong at baseline and followed their HbA1c level and cognitive status for 6 years. In line with the ADA recommendation, we defined the glycemic goal as HbA1c < 7.5%. The study outcome was incident dementia in 6 years, diagnosed according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) or Clinical Dementia Rating of 1–3. Results: those with HbA1c ≥ 7.5% at baseline and HbA1c < 7.5% in 1 year were associated with higher rather than lower incidence of dementia, independent of severe hypoglycemia, glycemic variability and other health factors. Sensitivity analyses showed that a relative reduction of ≥10%, but not 5–10%, in HbA1c within a year was associated with higher incidence of dementia in those with high (≥8%) and moderate (6.5–7.9%) HbA1c at baseline. Conclusion: a large reduction in HbA1c could be a potential predictor and possibly a risk factor for dementia in older adults with type 2 diabetes. Our findings suggest that optimizing or intensifying glycemic control in this population requires caution.
Persistent Identifierhttp://hdl.handle.net/10722/278252
ISSN
2017 Impact Factor: 4.013
2015 SCImago Journal Rankings: 1.611

 

DC FieldValueLanguage
dc.contributor.authorLee, ATC-
dc.contributor.authorRichards, M-
dc.contributor.authorChan, WC-
dc.contributor.authorChiu, HFK-
dc.contributor.authorLee, RSY-
dc.contributor.authorLam, LCW-
dc.date.accessioned2019-10-04T08:10:25Z-
dc.date.available2019-10-04T08:10:25Z-
dc.date.issued2019-
dc.identifier.citationAge and Ageing, 2019, v. 48 n. 6, p. 838-844-
dc.identifier.issn0002-0729-
dc.identifier.urihttp://hdl.handle.net/10722/278252-
dc.description.abstractBackground: although type 2 diabetes increases risk of dementia by 2-fold, whether optimizing glycemic level in late life can reduce risk of dementia remains uncertain. We examined if achieving the glycemic goal recommended by the American Diabetes Association (ADA) within a year was associated with lower risk of dementia in 6 years. Methods; in this population-based observational study, we examined 2246 community-living dementia-free Chinese older adults with type 2 diabetes who attended the Elderly Health Centres in Hong Kong at baseline and followed their HbA1c level and cognitive status for 6 years. In line with the ADA recommendation, we defined the glycemic goal as HbA1c < 7.5%. The study outcome was incident dementia in 6 years, diagnosed according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) or Clinical Dementia Rating of 1–3. Results: those with HbA1c ≥ 7.5% at baseline and HbA1c < 7.5% in 1 year were associated with higher rather than lower incidence of dementia, independent of severe hypoglycemia, glycemic variability and other health factors. Sensitivity analyses showed that a relative reduction of ≥10%, but not 5–10%, in HbA1c within a year was associated with higher incidence of dementia in those with high (≥8%) and moderate (6.5–7.9%) HbA1c at baseline. Conclusion: a large reduction in HbA1c could be a potential predictor and possibly a risk factor for dementia in older adults with type 2 diabetes. Our findings suggest that optimizing or intensifying glycemic control in this population requires caution.-
dc.languageeng-
dc.publisherOxford University Press. The Journal's web site is located at http://ageing.oxfordjournals.org/-
dc.relation.ispartofAge and Ageing-
dc.rightsPre-print: Journal Title] ©: [year] [owner as specified on the article] Published by Oxford University Press [on behalf of xxxxxx]. All rights reserved. Pre-print (Once an article is published, preprint notice should be amended to): This is an electronic version of an article published in [include the complete citation information for the final version of the Article as published in the print edition of the Journal.] Post-print: This is a pre-copy-editing, author-produced PDF of an article accepted for publication in [insert journal title] following peer review. The definitive publisher-authenticated version [insert complete citation information here] is available online at: xxxxxxx [insert URL that the author will receive upon publication here].-
dc.subjectdementia-
dc.subjectglycemic changes-
dc.subjectolder adults-
dc.subjecttype 2 diabetes-
dc.titleHigher dementia incidence in older adults with type 2 diabetes and large reduction in HbA1c-
dc.typeArticle-
dc.identifier.emailChan, WC: waicchan@hku.hk-
dc.identifier.authorityChan, WC=rp01687-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1093/ageing/afz108-
dc.identifier.pmid31574142-
dc.identifier.scopuseid_2-s2.0-85074184209-
dc.identifier.hkuros307049-
dc.identifier.volume48-
dc.identifier.issue6-
dc.identifier.spage838-
dc.identifier.epage844-
dc.publisher.placeUnited Kingdom-

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