Background
Methods
Study design and patients
Clinical data collection and examination method
Assessment of cognitive function
Definitions and follow up
Statistical analysis
Results
Baseline characteristics
Characteristics | Total (n = 1519) | Low group HbA1c < 7% (n = 883) | Median group 7% ≤ HbA1c < 8% (n = 333) | High group HbA1c ≥8% (n = 303) | P |
---|---|---|---|---|---|
Age (mean ± SD), years | 72 ± 6.3 | 71.8 ± 6.3 | 72.3 ± 6.3 | 72.1 ± 6 | 0.371 |
Age, years, n (%) | |||||
55–64 | 249 (16.4) | 155 (17.6) | 52 (15.6) | 42 (13.9) | 0.483 |
65–74 | 723 (47.6) | 413 (46.8) | 155 (46.5) | 155 (51.2) | |
≥ 75 | 547 (36) | 315 (35.7) | 126 (37.8) | 106 (35) | |
Cr | 70.2 ± 26.2 | 70.3 ± 30.1 | 70.9 ± 19 | 69.2 ± 20.4 | 0.701 |
GLU | 6.7 ± 2.1 | 5.8 ± 0.9 | 7 ± 1.1 | 9.2 ± 3.2 | < 0.001 |
HbA1c | 7 ± 1.6 | 6 ± 0.6 | 7.4 ± 0.3 | 9.5 ± 1.6 | < 0.001 |
HDL | 1.3 ± 0.3 | 1.3 ± 0.3 | 1.3 ± 0.3 | 1.3 ± 0.3 | 0.361 |
LDL | 2.9 ± 0.7 | 2.9 ± 0.8 | 2.9 ± 0.7 | 2.9 ± 0.8 | 0.971 |
TC | 5.2 ± 1 | 5.2 ± 1.1 | 5.2 ± 1 | 5.2 ± 1 | 0.965 |
TG | 1.7 ± 1 | 1.6 ± 0.9 | 1.7 ± 0.8 | 1.8 ± 1.4 | 0.01 |
UA | 327.1 ± 89.7 | 326.3 ± 86.5 | 339.3 ± 95 | 316.1 ± 91.5 | 0.005 |
ApoE23 | 1078 (90.4) | 621 (91.2) | 241 (90.9) | 216 (87.4) | 0.218 |
ApoE4 | 115 (9.6) | 60 (8.8) | 24 (9.1) | 31 (12.6) | |
Sex | |||||
male | 580 (38.2) | 345 (39.1) | 126 (37.8) | 109 (36) | 0.625 |
female | 939 (61.8) | 538 (60.9) | 207 (62.2) | 194 (64) | |
Education | |||||
Elementary school and below | 534 (36.1) | 280 (32.6) | 137 (42.2) | 117 (39.9) | 0.003 |
High school and above | 944 (63.9) | 580 (67.4) | 188 (57.8) | 176 (60.1) | |
Live Alone | |||||
yes | 104 (6.9) | 64 (7.3) | 23 (6.9) | 17 (5.6) | 0.619 |
no | 1413 (93.1) | 818 (92.7) | 309 (93.1) | 286 (94.4) | |
income | |||||
The monthly per capita income in the family ≤3000 | 1098 (79.6) | 643 (80.8) | 235 (77.3) | 220 (78.9) | 0.413 |
The monthly per capita income in the family > 3000 | 281 (20.4) | 153 (19.2) | 69 (22.7) | 59 (21.1) | |
Participation in healthcare seminar/consulting at least once a month | |||||
yes | 902 (61.2) | 534 (62.4) | 195 (59.8) | 173 (59.2) | 0.539 |
no | 572 (38.8) | 322 (37.6) | 131 (40.2) | 119 (40.8) | |
smoke | |||||
no | 1361 (89.6) | 795 (90) | 303 (91) | 263 (86.8) | 0.181 |
yes | 158 (10.4) | 88 (10) | 30 (9) | 40 (13.2) | |
drink | |||||
no | 1334 (87.8) | 774 (87.7) | 287 (86.2) | 273 (90.1) | 0.313 |
yes | 185 (12.2) | 109 (12.3) | 46 (13.8) | 30 (9.9) | |
Physical Activity | |||||
Exercise less than 30 min/day | 363 (24.6) | 218 (25.3) | 78 (24) | 67 (22.9) | 0.671 |
Exercise more than 30 min/day | 1115 (75.4) | 642 (74.7) | 247 (76) | 226 (77.1) | |
High-protein diet | |||||
High-protein diet<=1 item | 276 (18.2) | 160 (18.1) | 50 (15) | 66 (21.8) | 0.087 |
High-protein diet: 2–3 items | 1243 (81.8) | 723 (81.9) | 283 (85) | 237 (78.2) | |
Intake of fruits/vegetables more than twice a day | |||||
no | 165 (10.9) | 90 (10.2) | 33 (9.9) | 42 (13.9) | 0.171 |
yes | 1354 (89.1) | 793 (89.8) | 300 (90.1) | 261 (86.1) | |
BMI | |||||
normal | 534 (35.2) | 346 (39.2) | 98 (29.4) | 90 (29.7) | 0.001 |
Overweight or obesity | 984 (64.8) | 536 (60.8) | 235 (70.6) | 213 (70.3) | |
CVD History | |||||
no | 748 (49.2) | 417 (47.2) | 166 (49.8) | 165 (54.5) | 0.092 |
yes | 771 (50.8) | 466 (52.8) | 167 (50.2) | 138 (45.5) | |
CED History | |||||
no | 1131 (74.5) | 646 (73.2) | 244 (73.3) | 241 (79.5) | 0.077 |
yes | 388 (25.5) | 237 (26.8) | 89 (26.7) | 62 (20.5) | |
HP History | |||||
no | 128 (8.4) | 85 (9.6) | 26 (7.8) | 17 (5.6) | 0.085 |
yes | 1391 (91.6) | 798 (90.4) | 307 (92.2) | 286 (94.4) | |
MMSE score (baseline) | 28.5 ± 2.2 | 28.5 ± 2.2 | 28.4 ± 2.2 | 28.6 ± 2.4 | 0.51 |
MMSE score (follow-up) | 27.3 ± 3.6 | 27.4 ± 3.3 | 27.3 ± 3.9 | 26.9 ± 3.8 | 0.086 |
MMSE variation | −1.2 ± 3.5 | −1.1 ± 3.3 | −1.1 ± 3.6 | −1.7 ± 3.6 | 0.022 |
Linear regression analysis of factors related to the severity of the decline in MMSE score
Characteristics | Beta (95%CI) | P-value |
---|---|---|
Female | 0.15 (− 0.29–0.59) | 0.505 |
Age, years | ||
55–64 | 1 | |
65–74 | − 0.06 (− 0.56–0.43) | 0.798 |
≥ 75 | 0.97 (0.42–1.51) | 0.001 |
Elementary school and below | 1.17 (0.75–1.59) | < 0.001 |
Lives alone, no | 0.44 (−0.25–1.13) | 0.208 |
Participation in healthcare seminars/consultation at least once a month, no | 0.43 (0.08–0.78) | 0.017 |
Smoker | 0.03 (−0.59–0.65) | 0.919 |
Drinking alcohol | −0.18 (− 0.76–0.41) | 0.55 |
Physical Activity of more than 30 min/day | −0.4 (− 0.8–0) | 0.05 |
High-protein diet: 2–3 items | 0.3 (− 0.15–0.75) | 0.197 |
Intake of fruits/vegetables more than twice a day, yes | 0.08 (− 0.48–0.64) | 0.773 |
Overweight or obese | −0.11 (− 0.48–0.26) | 0.555 |
CVD History, yes | 0.05 (− 0.3–0.39) | 0.793 |
CED History, yes | 0.49 (0.1–0.89) | 0.015 |
HP History, yes | −0.23 (− 0.86–0.4) | 0.476 |
MMSE score (baseline) | 0.56 (0.47–0.64) | < 0.001 |
TG | −0.04 (− 0.26–0.17) | 0.7 |
TC | 0.08 (−0.41–0.57) | 0.75 |
HDL | −0.21 (− 0.92–0.51) | 0.571 |
LDL | −0.19 (− 0.81–0.44) | 0.56 |
UA | 0 (0–0) | 0.972 |
Cr | 0.01 (0–0.01) | 0.099 |
HbA1c | ||
7% ≤ HbA1c < 8% | 1 | |
HbA1c < 7% | 0.05 (−0.37–0.48) | 0.808 |
HbA1c ≥8% | 0.61 (0.08–1.14) | 0.024 |
Characteristics | Beta 95%CI | P-value |
---|---|---|
Age, years | ||
55–64 | 1 | |
65–74 | −0.05 (−0.54–0.44) | 0.841 |
≥ 75 | 0.99 (0.45–1.52) | < 0.001 |
Elementary school and below | 1.18 (0.78–1.58) | < 0.001 |
Participation in healthcare seminar/consulting at least once a month, no | 0.42 (0.07–0.77) | 0.018 |
Physical activity for more than 30 min/day | −0.44 (−0.83--0.05) | 0.029 |
CED History, yes | 0.48 (0.09–0.87) | 0.015 |
MMSE score (baseline) | 0.57 (0.49–0.65) | < 0.001 |
HbA1c | ||
7% ≤ HbA1c < 8% | 1 | |
HbA1c < 7% | 0.05 (−0.37–0.47) | 0.807 |
HbA1c ≥8% | 0.58 (0.06–1.11) | 0.029 |
Logistic regression analysis of factors related to the decline in MMSE score
Characteristics | OR_95CI | P_value |
---|---|---|
Female | 0.94 (0.77–1.14) | 0.508 |
Age, years | ||
55–64 | 1 | |
65–74 | 1.13 (0.87–1.48) | 0.363 |
≥ 75 | 1.66 (1.26–2.19) | < 0.001 |
Elementary school and below | 0.83 (0.68–1.01) | 0.069 |
Lives alone, no | 1.3 (0.9–1.88) | 0.162 |
Participation in healthcare seminars/consultation at least once a month, no | 1.09 (0.89–1.32) | 0.402 |
Smoker | 1.07 (0.79–1.46) | 0.648 |
Drinking alcohol | 0.97 (0.73–1.29) | 0.837 |
Physical Activity of more than 30 min/day | 0.77 (0.62–0.96) | 0.022 |
High-protein diet: 2–3 items | 1.25 (0.98–1.6) | 0.066 |
Intake of fruits/vegetables more than twice a day, yes | 0.75 (0.55–1.01) | 0.061 |
Overweight or obese | 0.93 (0.76–1.13) | 0.443 |
CVD History, yes | 1.06 (0.88–1.27) | 0.57 |
CED History, yes | 1.16 (0.94–1.44) | 0.177 |
HP History, yes | 1.16 (0.83–1.63) | 0.373 |
MMSE score (baseline) | 1.41 (1.35–1.49) | < 0.001 |
TG | 0.99 (0.9–1.08) | 0.773 |
TC | 0.92 (0.84–1.01) | 0.067 |
HDL | 0.82 (0.61–1.12) | 0.21 |
LDL | 0.85 (0.75–0.96) | 0.01 |
UA | 1 (1–1) | 0.629 |
Cr | 1 (1–1.01) | 0.063 |
HbA1c | ||
7% ≤ HbA1c < 8% | 1 | |
HbA1c < 7% | 1.13 (0.89–1.42) | 0.314 |
HbA1c ≥8% | 1.52 (1.13–2.03) | 0.005 |
Characteristics | OR_95CI | P-value |
---|---|---|
Female | 1.19 (0.92–1.55) | 0.185 |
Age, years | ||
55–64 | 1 | |
65–74 | 1.12 (0.84–1.49) | 0.456 |
≥ 75 | 1.97 (1.43–2.72) | < 0.001 |
Elementary school and below | 1.91 (1.48–2.45) | < 0.001 |
Lives Alone, no | 1.36 (0.9–2.06) | 0.144 |
Participation in healthcare seminar/consulting at least once a month, no | 1.28 (1.04–1.58) | 0.022 |
smoke | 1.11 (0.77–1.6) | 0.588 |
drink | 0.86 (0.61–1.21) | 0.383 |
PhyAct more than 30 min/day | 0.79 (0.62–1) | 0.048 |
High-protein diet: 2–3 items | 1.14 (0.87–1.49) | 0.344 |
Intake of fruits/vegetables more than twice a day, yes | 0.84 (0.6–1.17) | 0.302 |
Overweight or obesity | 0.99 (0.8–1.23) | 0.937 |
CVD His, yes | 1.06 (0.86–1.3) | 0.601 |
CED His, yes | 1.3 (1.03–1.64) | 0.029 |
HP His, yes | 0.92 (0.63–1.34) | 0.67 |
MMSE score (baseline) | 1.56 (1.47–1.66) | < 0.001 |
TG | 0.97 (0.85–1.1) | 0.644 |
TC | 1.09 (0.81–1.46) | 0.585 |
HDL | 0.9 (0.59–1.39) | 0.644 |
LDL | 0.84 (0.58–1.23) | 0.373 |
UA | 1 (1–1) | 0.51 |
Cr | 1 (1–1.01) | 0.49 |
HbA1c | ||
7% ≤ HbA1c < 8% | 1 | |
HbA1c < 7% | 1.18 (0.91–1.51) | 0.205 |
HbA1c ≥8% | 1.55 (1.13–2.12) | 0.007 |