Abstract
OBJECTIVE In children with type 1 diabetes (T1D), severe hypoglycemia (SH) is associated with poorer cognition, but the association of SH with cognitive function in late life is unknown. Given the increasing life expectancy in people with T1D, understanding the role of SH in brain health is crucial. RESEARCH DESIGN AND METHODS We examined the association between SH and cognitive function in 718 older adults with T1D from the Study of Longevity in Diabetes (SOLID). Subjects self-reported recent SH (previous 12 months) and lifetime history of SH resulting in inpatient/emergency department utilization. Global and domain-specific cognition (language, executive function, episodic memory, and simple attention) were assessed. The associations of SH with cognitive function and impaired cognition were evaluated via linear and logistic regression models, respectively. RESULTS Thirty-two percent of participants (mean age 67.2 years) reported recent SH and 50% reported lifetime SH. Compared with those with no SH, subjects with a recent SH history had significantly lower global cognition scores. Domain-specific analyses revealed significantly lower scores on language, executive function, and episodic memory with recent SH exposure and significantly lower executive function with lifetime SH exposure. Recent SH was associated with impaired global cognition (odds ratio [OR] 3.22, 95% CI 1.30, 7.94) and cognitive impairment on the language domain (OR 3.15, 95% CI 1.19, 8.29). CONCLUSIONS Among older adults with T1D, recent SH and lifetime SH were associated with worse cognition. Recent SH was associated with impaired global cognition. These findings suggest a deleterious role of SH on the brain health of older patients with T1D and highlight the importance of SH prevention.
| Original language | English |
|---|---|
| Pages (from-to) | 541-548 |
| Number of pages | 8 |
| Journal | Diabetes Care |
| Volume | 43 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2020 |
Bibliographical note
Publisher Copyright:© 2019 by the American Diabetes Association.
Funding
The authors gratefully acknowledge funding from the National Institute on Aging, National Institutes of Health (NIA R01 AG047500 [to R.A.W.]). M.E.L. and C.E. were supported by the University of California, San Francisco, Training for Research on Aging and Chronic Disease program (NIA T32 AG049663). M.E.L. was also supported by the Patient-Centered Outcomes Research Institute through contract PPRN-1306-04709. Funding. The authors gratefully acknowledge funding from the National Institute on Aging, National Institutes of Health (NIA R01 AG047500 [to R.A.W.]). M.E.L. and C.E. were supported by theUniversityofCalifornia,SanFrancisco,Training for Research on Aging and Chronic Disease program (NIA T32 AG049663). M.E.L. was also supported by the Patient-Centered Outcomes Research Institute through contract PPRN-1306-04709.
| Funders | Funder number |
|---|---|
| National Institutes of Health (NIH) | |
| National Institute on Aging | T32 AG049663, R01AG047500 |
| National Institute on Aging | |
| University of California, Los Angeles | |
| Patient-Centered Outcomes Research Institute | PPRN-1306-04709 |
| Patient-Centered Outcomes Research Institute |
ASJC Scopus subject areas
- Internal Medicine
- Endocrinology, Diabetes and Metabolism
- Advanced and Specialized Nursing
