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. 2024 Apr 29;47(7):1152–1161. doi: 10.2337/dc23-2003

Table 2.

Association between HbA1c and glycemic control (independently) and cognitive change (average 7 years from visit 1; laboratory measurement of HbA1c) in SOL-INCA

b [95% CI]
M1 M2 M3 M4 M5
Global cognition
 HbA1c (%) −0.059*** [−0.084; −0.035] −0.051*** [−0.076; −0.027] −0.046*** [−0.070; −0.021] −0.046*** [−0.070; −0.022] −0.045*** [−0.070; −0.021]
 Glycemic control (HbA1c)
  No diabetes Ref. Ref. Ref. Ref. Ref.
  Prediabetes 0.05 [−0.04; 0.13] 0.06 [−0.02; 0.15] 0.08 [−0.01; 0.16] 0.08 [−0.01; 0.16] 0.08 [−0.00; 0.17]
  Controlled −0.07 [−0.25; 0.11] −0.05 [−0.22; 0.12] −0.04 [−0.21; 0.13] −0.04 [−0.21; 0.13] −0.04 [−0.21; 0.12]
  Poorly controlled −0.26*** [−0.37; −0.15] −0.23*** [−0.34; −0.12] −0.19*** [−0.30; −0.08] −0.19*** [−0.30; −0.08] −0.18** [−0.29; −0.07]
  Unweighted n 5,874 5,874 5,874 5,874 5,874
B-SEVLT sum
 HbA1c (%) −0.029* [−0.052; −0.006] −0.020 [−0.042; 0.002] −0.013 [−0.035; 0.009] −0.013 [−0.034; 0.009] −0.013 [−0.035; 0.008]
 Glycemic control (HbA1c)
  No diabetes Ref. Ref. Ref. Ref. Ref.
  Prediabetes 0.04 [−0.05; 0.13] 0.06 [−0.03; 0.15] 0.08 [−0.01; 0.17] 0.08 [−0.01; 0.17] 0.08 [−0.01; 0.17]
  Controlled −0.05 [−0.23; 0.13] −0.03 [−0.19; 0.14] −0.02 [−0.18; 0.15] −0.02 [−0.18; 0.15] −0.03 [−0.20; 0.14]
  Poorly controlled −0.16** [−0.26; −0.06] −0.12* [−0.22; −0.02] −0.07 [−0.16; 0.03] −0.06 [−0.16; 0.03] −0.07 [−0.16; 0.03]
  Unweighted n 5,858 5,858 5,858 5,858 5,858
B-SEVLT recall
 HbA1c (%) −0.019 [−0.044; 0.005] −0.014 [−0.039; 0.011] −0.010 [−0.035; 0.014] −0.009 [−0.034; 0.015] −0.012 [−0.036; 0.012]
 Glycemic control (HbA1c)
  No diabetes Ref. Ref. Ref. Ref. Ref.
  Prediabetes 0.03 [−0.05; 0.11] 0.04 [−0.04; 0.12] 0.05 [−0.03; 0.13] 0.05 [−0.03; 0.13] 0.04 [−0.04; 0.12]
  Controlled −0.08 [−0.27; 0.12] −0.06 [−0.25; 0.13] −0.05 [−0.24; 0.13] −0.05 [−0.24; 0.14] −0.08 [−0.27; 0.10]
  Poorly controlled −0.14** [−0.24; −0.04] −0.12* [−0.22; −0.01] −0.08 [−0.18; 0.02] −0.08 [−0.18; 0.02] −0.09 [−0.20; 0.01]
  Unweighted n 5,849 5,849 5,849 5,849 5,849
WF
 HbA1c (%) −0.051*** [−0.078; −0.024] −0.041** [−0.068; −0.015] −0.040** [−0.066; −0.014] −0.037** [−0.063; −0.012] −0.034* [−0.060; −0.008]
 Glycemic control (HbA1c)
  No diabetes Ref. Ref. Ref. Ref. Ref.
  Prediabetes 0.00 [−0.09; 0.09] 0.02 [−0.07; 0.11] 0.02 [−0.07; 0.11] 0.02 [−0.07; 0.11] 0.03 [−0.06; 0.12]
  Controlled 0.02 [−0.14; 0.18] 0.06 [−0.10; 0.21] 0.06 [−0.10; 0.21] 0.06 [−0.09; 0.21] 0.06 [−0.08; 0.21]
  Poorly controlled −0.23*** [−0.34; −0.11] −0.18** [−0.30; −0.07] −0.19** [−0.30; −0.07] −0.18** [−0.29; −0.06] −0.16** [−0.27; −0.04]
  Unweighted n 5,781 5,781 5,781 5,781 5,781
DSS
 HbA1c (%) −0.100*** [−0.129; −0.070] −0.093*** [−0.123; −0.063] −0.093*** [−0.123; −0.063] −0.094*** [−0.124; −0.064] −0.090*** [−0.120; −0.059]
 Glycemic control (HbA1c)
  No diabetes Ref. Ref. Ref. Ref. Ref.
  Prediabetes 0.06 [−0.03; 0.14] 0.07 [−0.01; 0.16] 0.07 [−0.01; 0.16] 0.07 [−0.01; 0.16] 0.09* [0.00; 0.18]
  Controlled −0.12 [−0.32; 0.07] −0.10 [−0.30; 0.09] −0.10 [−0.30; 0.09] −0.10 [−0.30; 0.09] −0.08 [−0.28; 0.12]
  Poorly controlled −0.31*** [−0.43; −0.19] −0.28*** [−0.40; −0.16] −0.28*** [−0.40; −0.16] −0.28*** [−0.40; −0.16] −0.26*** [−0.38; −0.13]
  Unweighted n 5,718 5,718 5,718 5,718 5,718

B-SEVLT focused on verbal episodic learning and memory, and DSS focused on executive function and processing speed. M1 adjusts for age, sex; M2 adds education; M3 adds additional adjustment for Hispanic/Latino heritage and study site (center); M4 adds depressive symptoms; M5 adds diet, physical activity, BMI, alcohol consumption, and smoking. Global cognition includes the consistently measured cognitive tests only (B-SEVLT sum and recall, WF, and DSS; excludes Trails A and B). For the categorical measure, the no diabetes group is the reference (ref.) in the models used to calculate the marginal estimates.

*

<.05

**

<.01

***

<.001