The journal of nutrition, health & aging

, Volume 15, Issue 6, pp 445–449

Improved diabetes control in the elderly delays global cognitive decline

  • José A. Luchsinger
  • Walter Palmas
  • J. A. Teresi
  • S. Silver
  • J. Kong
  • J. P. Eimicke
  • R. S. Weinstock
  • S. Shea
  • Ideatel Consortium
JNHA: Clinical Neurosciences

DOI: 10.1007/s12603-011-0057-x

Cite this article as:
Luchsinger, J.A., Palmas, W., Teresi, J.A. et al. J Nutr Health Aging (2011) 15: 445. doi:10.1007/s12603-011-0057-x

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.

Key words

Diabetes treatment cognitive impairment clinical trials 

Copyright information

© Serdi and Springer Verlag France 2011

Authors and Affiliations

  • José A. Luchsinger
    • 1
    • 2
    • 9
  • Walter Palmas
    • 1
  • J. A. Teresi
    • 3
    • 4
    • 5
  • S. Silver
    • 3
  • J. Kong
    • 3
  • J. P. Eimicke
    • 3
  • R. S. Weinstock
    • 6
    • 7
  • S. Shea
    • 1
    • 2
    • 8
  • Ideatel Consortium
  1. 1.Department of MedicineColumbia UniversityNew YorkUSA
  2. 2.Department of Epidemiology, Joseph Mailman School of Public HealthColumbia UniversityNew YorkUSA
  3. 3.Research DivisionHebrew Home at RiverdaleBronxUSA
  4. 4.Stroud CenterColumbia UniversityColumbiaUSA
  5. 5.New York State Psychiatric InstituteNew YorkUSA
  6. 6.Joslin Diabetes Center and Division of Endocrinology, Diabetes and MetabolismSUNY Upstate Medical UniversitySyracuseUSA
  7. 7.Department of Veterans AffairsVA Medical CenterSyracuseUSA
  8. 8.Department of Biomedical InformaticsColumbia UniversityNew YorkUSA
  9. 9.Division of General Medicine, PH9East-105New YorkUSA

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