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J Nutr Health Aging. 2011 Jun;15(6):445-9.

Improved diabetes control in the elderly delays global cognitive decline.

Author information

  • 1Department of Medicine, Columbia University, Division of General Medicine, PH9East-105, 630 West 168th street, New York, NY 10032, USA. jal94@columbia.edu

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.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00271739.

PMID:
21623465
PMCID:
PMC3328757
[PubMed - indexed for MEDLINE]
Free PMC Article
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