Figure 1.

Difference in global cognitive Z score decline by clinical categories of hemoglobin A1c compared to decline in persons without diabetes with hemoglobin A1c < 5.7%.

Legend: Adjusted for attrition refers to the inverse probability of attrition weighting used to account for participant death or dropout during follow-up. Estimates (95% confidence intervals) are from generalized linear models fit using generalized estimating equations for global cognitive Z score, with adjustment for age, age-squared, race-center, sex, education, cigarette smoking status, drinking status, hypertension, history of coronary heart disease, history of stroke, APOE ε4 genotype, body mass index, interactions between these variables and time (except for drinking status and history of coronary heart disease, which were not significant), and interactions between race-center and sex, hypertension, and education. Hemoglobin A1c was categorized using the standard clinical cut-points based on American Diabetes Association criteria (in participants without a diagnosis of diabetes (N=12,107): <5.7% (N=9,031), 5.7-6.4% (N=2,365), and ≥6.5% (N=711); in participants with diagnosed diabetes(N=1,244): <7% (N=415), ≥7% (N=829).