Improved diabetes control in the elderly delays global cognitive decline.

ABSTRACT: OBJECTIVES:To examine whether improved diabetes control is related to better cognitive outcomes. DESIGN:Randomized control trial. SETTING:A randomized trial of telemedicine vs. usual care in elderly persons with type 2 diabetes. PARTICIPANTS:Participants were 2169 persons 55 years and older with type 2 diabetes from New York City and Upstate New York. INTERVENTION:The diabetes case management intervention was implemented by a diabetes nurse, via a telemedicine unit in the participant's home, and in coordination with the primary care physician. MEASUREMENTS:Hemoglobin A1c (HbA1c), systolic blood pressure (SBP), and low density lipoprotein cholesterol (LDL), were measured at a baseline visit and at up to 5 annual follow-up visits. Global cognition was measured at those visits with the Comprehensive Assessment and Referral Evaluation (CARE). RESULT:In mixed models the intervention was related to slower global cognitive decline in the intervention group (p = 0.01). Improvements in HbA1c (p = 0.03), but not SBP or LDL, mediated the effect of the intervention on cognitive decline. CONCLUSION:Improved diabetes control in the elderly following existing guidelines through a telemedicine intervention was associated with less global cognitive decline. The main mediator of this effect seemed to be improvements in HbA1c.

SUBMITTER: Luchsinger JA 

PROVIDER: S-EPMC3328757 | biostudies-literature | 2011 Jun

REPOSITORIES: biostudies-literature