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A Longitudinal Investigation of Prediabetes, Diabetes, HbA1c and Cognitive Trajectories Among Cognitively Unimpaired Individuals.

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Title: A Longitudinal Investigation of Prediabetes, Diabetes, HbA1c and Cognitive Trajectories Among Cognitively Unimpaired Individuals.
Authors: Pink, Anna, Krell‐Roesch, Janina, Syrjanen, Jeremy A., Vassilaki, Maria, Fields, Julie A., Iglseder, Bernhard, Aigner, Elmar, Kremers, Walter K., Jack, Clifford R., Racette, Susan B., Petersen, Ronald C., Geda, Yonas E.
Source: Journal of the American Geriatrics Society. Feb2026, Vol. 74 Issue 2, p345-354. 10p.
Subjects: Prediabetic state, Language & languages, Glycosylated hemoglobin, Disease duration, Body mass index, Hyperlipidemia, Wechsler Memory Scale, Executive function, Sex distribution, Hypertension, Smoking, Age distribution, Longitudinal method, Attention, Cognition disorders, Memory, Neuropsychological tests, Coronary artery disease, Data analysis software, Diabetes, Educational attainment, Wechsler Adult Intelligence Scale
Geographic Terms: United States
Abstract: Background: Previous studies on the relationship between prediabetes, HbA1c and cognitive trajectories show mixed results. Therefore, we investigated the association of prediabetes, diabetes and HbA1c with change in global and domain‐specific cognitive scores in cognitively unimpaired (CU) adults, as well as the potential effect modification by sex or age. Methods: This longitudinal study included 4236 CU persons aged ≥ 50 years from the population‐based Mayo Clinic Study of Aging. We ran linear mixed‐effect models with baseline prediabetes, diabetes and HbA1c predicting longitudinal global and domain‐specific (i.e., memory, language, attention/executive function, and visuospatial skills) cognitive z‐scores and raw scores. Models were adjusted for age, sex, education, medical comorbidity, repeated cognitive testing, and ApoEɛ4. We additionally ran models with sex and age interactions. Results: Compared to normoglycemic individuals, individuals with prediabetes and diabetes showed poorer performance on cognitive tests, i.e., TMT‐B, category fluency, and block design subtest over time. Additionally, the presence of prediabetes, diabetes, longer diabetes duration and higher HbA1c were associated with faster global and domain‐specific cognitive decline over a median follow‐up of 6.4 years (range 1–19). Three‐way interactions showed that the effect of diabetes on decline in global cognition, attention and visuospatial domains was more pronounced in women than in men. Age did not modify the effect of diabetes or higher HbA1c on cognition. Conclusions: The results suggest that prediabetes and diabetes significantly shorten the timeframe before a potentially clinically noticeable change in global and domain‐specific cognition is reached. Thus, lifestyle modification to reverse prediabetes and prevent diabetes could potentially reduce the rate of cognitive decline in aging populations. The findings differed by sex (i.e., the effect of diabetes on decline in global cognition, attention and visuospatial domains was more pronounced in women than men). Summary: Key points ○Compared to normoglycemic individuals, individuals with prediabetes and diabetes showed poorer performance on cognitive tests, i.e., TMT‐B, category fluency, and block design subtest over time.○Overall, the findings suggest that prediabetes, diabetes, longer diabetes duration, and higher HbA1c in individuals with and without diabetes are associated with a global cognitive decline rather than a specific cognitive domain.○Diabetes had a stronger effect on cognitive decline in women than men.Why does this matter? ○Treatment of prediabetes and prevention of diabetes in cognitively unimpaired individuals may attenuate the trajectory of cognitive decline, highlighting the potential of lifestyle modification. Geriatricians and other specialists may want to follow closely patients with prediabetes and diabetes, and in particular, women with diabetes, for early detection or referral to cognitive neurology and neuropsychology practice. [ABSTRACT FROM AUTHOR]
Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: A Longitudinal Investigation of Prediabetes, Diabetes, HbA1c and Cognitive Trajectories Among Cognitively Unimpaired Individuals.
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  Data: <searchLink fieldCode="AR" term="%22Pink%2C+Anna%22">Pink, Anna</searchLink><br /><searchLink fieldCode="AR" term="%22Krell‐Roesch%2C+Janina%22">Krell‐Roesch, Janina</searchLink><br /><searchLink fieldCode="AR" term="%22Syrjanen%2C+Jeremy+A%2E%22">Syrjanen, Jeremy A.</searchLink><br /><searchLink fieldCode="AR" term="%22Vassilaki%2C+Maria%22">Vassilaki, Maria</searchLink><br /><searchLink fieldCode="AR" term="%22Fields%2C+Julie+A%2E%22">Fields, Julie A.</searchLink><br /><searchLink fieldCode="AR" term="%22Iglseder%2C+Bernhard%22">Iglseder, Bernhard</searchLink><br /><searchLink fieldCode="AR" term="%22Aigner%2C+Elmar%22">Aigner, Elmar</searchLink><br /><searchLink fieldCode="AR" term="%22Kremers%2C+Walter+K%2E%22">Kremers, Walter K.</searchLink><br /><searchLink fieldCode="AR" term="%22Jack%2C+Clifford+R%2E%22">Jack, Clifford R.</searchLink><br /><searchLink fieldCode="AR" term="%22Racette%2C+Susan+B%2E%22">Racette, Susan B.</searchLink><br /><searchLink fieldCode="AR" term="%22Petersen%2C+Ronald+C%2E%22">Petersen, Ronald C.</searchLink><br /><searchLink fieldCode="AR" term="%22Geda%2C+Yonas+E%2E%22">Geda, Yonas E.</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+the+American+Geriatrics+Society%22">Journal of the American Geriatrics Society</searchLink>. Feb2026, Vol. 74 Issue 2, p345-354. 10p.
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  Data: <searchLink fieldCode="DE" term="%22Prediabetic+state%22">Prediabetic state</searchLink><br /><searchLink fieldCode="DE" term="%22Language+%26+languages%22">Language & languages</searchLink><br /><searchLink fieldCode="DE" term="%22Glycosylated+hemoglobin%22">Glycosylated hemoglobin</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+duration%22">Disease duration</searchLink><br /><searchLink fieldCode="DE" term="%22Body+mass+index%22">Body mass index</searchLink><br /><searchLink fieldCode="DE" term="%22Hyperlipidemia%22">Hyperlipidemia</searchLink><br /><searchLink fieldCode="DE" term="%22Wechsler+Memory+Scale%22">Wechsler Memory Scale</searchLink><br /><searchLink fieldCode="DE" term="%22Executive+function%22">Executive function</searchLink><br /><searchLink fieldCode="DE" term="%22Sex+distribution%22">Sex distribution</searchLink><br /><searchLink fieldCode="DE" term="%22Hypertension%22">Hypertension</searchLink><br /><searchLink fieldCode="DE" term="%22Smoking%22">Smoking</searchLink><br /><searchLink fieldCode="DE" term="%22Age+distribution%22">Age distribution</searchLink><br /><searchLink fieldCode="DE" term="%22Longitudinal+method%22">Longitudinal method</searchLink><br /><searchLink fieldCode="DE" term="%22Attention%22">Attention</searchLink><br /><searchLink fieldCode="DE" term="%22Cognition+disorders%22">Cognition disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Memory%22">Memory</searchLink><br /><searchLink fieldCode="DE" term="%22Neuropsychological+tests%22">Neuropsychological tests</searchLink><br /><searchLink fieldCode="DE" term="%22Coronary+artery+disease%22">Coronary artery disease</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Diabetes%22">Diabetes</searchLink><br /><searchLink fieldCode="DE" term="%22Educational+attainment%22">Educational attainment</searchLink><br /><searchLink fieldCode="DE" term="%22Wechsler+Adult+Intelligence+Scale%22">Wechsler Adult Intelligence Scale</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22United+States%22">United States</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Background: Previous studies on the relationship between prediabetes, HbA1c and cognitive trajectories show mixed results. Therefore, we investigated the association of prediabetes, diabetes and HbA1c with change in global and domain‐specific cognitive scores in cognitively unimpaired (CU) adults, as well as the potential effect modification by sex or age. Methods: This longitudinal study included 4236 CU persons aged ≥ 50 years from the population‐based Mayo Clinic Study of Aging. We ran linear mixed‐effect models with baseline prediabetes, diabetes and HbA1c predicting longitudinal global and domain‐specific (i.e., memory, language, attention/executive function, and visuospatial skills) cognitive z‐scores and raw scores. Models were adjusted for age, sex, education, medical comorbidity, repeated cognitive testing, and ApoEɛ4. We additionally ran models with sex and age interactions. Results: Compared to normoglycemic individuals, individuals with prediabetes and diabetes showed poorer performance on cognitive tests, i.e., TMT‐B, category fluency, and block design subtest over time. Additionally, the presence of prediabetes, diabetes, longer diabetes duration and higher HbA1c were associated with faster global and domain‐specific cognitive decline over a median follow‐up of 6.4 years (range 1–19). Three‐way interactions showed that the effect of diabetes on decline in global cognition, attention and visuospatial domains was more pronounced in women than in men. Age did not modify the effect of diabetes or higher HbA1c on cognition. Conclusions: The results suggest that prediabetes and diabetes significantly shorten the timeframe before a potentially clinically noticeable change in global and domain‐specific cognition is reached. Thus, lifestyle modification to reverse prediabetes and prevent diabetes could potentially reduce the rate of cognitive decline in aging populations. The findings differed by sex (i.e., the effect of diabetes on decline in global cognition, attention and visuospatial domains was more pronounced in women than men). Summary: Key points ○Compared to normoglycemic individuals, individuals with prediabetes and diabetes showed poorer performance on cognitive tests, i.e., TMT‐B, category fluency, and block design subtest over time.○Overall, the findings suggest that prediabetes, diabetes, longer diabetes duration, and higher HbA1c in individuals with and without diabetes are associated with a global cognitive decline rather than a specific cognitive domain.○Diabetes had a stronger effect on cognitive decline in women than men.Why does this matter? ○Treatment of prediabetes and prevention of diabetes in cognitively unimpaired individuals may attenuate the trajectory of cognitive decline, highlighting the potential of lifestyle modification. Geriatricians and other specialists may want to follow closely patients with prediabetes and diabetes, and in particular, women with diabetes, for early detection or referral to cognitive neurology and neuropsychology practice. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1111/jgs.70231
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      – Code: eng
        Text: English
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      – SubjectFull: Prediabetic state
        Type: general
      – SubjectFull: Language & languages
        Type: general
      – SubjectFull: Glycosylated hemoglobin
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      – SubjectFull: Disease duration
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      – SubjectFull: Executive function
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      – SubjectFull: Sex distribution
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      – SubjectFull: Hypertension
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      – SubjectFull: Smoking
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      – SubjectFull: Age distribution
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      – SubjectFull: Longitudinal method
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      – SubjectFull: Coronary artery disease
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      – TitleFull: A Longitudinal Investigation of Prediabetes, Diabetes, HbA1c and Cognitive Trajectories Among Cognitively Unimpaired Individuals.
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              Text: Feb2026
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