Health & body · 2023
Are blood sugar fluctuations linked to poorer memory-test performance and in people attending a memory clinic?
Yes: greater blood sugar variability was associated with lower scores on two cognitive tests in memory-clinic patients. Its relationship with medial temporal atrophy was nonlinear, with higher variability linked to higher atrophy scores when the variability measure, VIM, was below 2.42.
Details
Previous research has observed a significant association between glycemia and dementia. Medial temporal atrophy (MTA) is considered a common marker of dementia. However, the relationship between blood glucose variability and MTA remains unclear, as does whether glucose variability can serve as a biomarker of MTA and cognitive performance.
This clinic-based observational study enrolled memory-clinic patients who underwent brain MRI scans and cognitive assessments within the first week of their hospital visit. All participants had three fasting blood glucose assessments and one HbA1c assessment across three self-selected days within one week of their first visit. Glucose variability was assessed using variability independent of the mean (VIM). Validated visual scales were used to rate MTA. Cognitive function was assessed with the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA).
The researchers used Spearman’s correlation and regression models to examine relationships involving the MMSE and MoCA scales and links between MRI characteristics and cognitive status. Covariates were vascular risk factors, educational status, age, gender and mean glucose parameters.
The MMSE was completed by 461 participants, and the MoCA by 447. Men accounted for 47.72% of participants (220/461). The abstract reports the median age as 69.87 ± 5.37 years.
Spearman’s analysis showed strong negative correlations between VIM and MMSE scores (r = −0.729, P < 0.01) and between VIM and MoCA scores (r = −0.710, P < 0.01). VIM was identified as an independent risk factor for cognitive impairment assessed by both MMSE and MoCA. Sensitivity analysis did not change the results. A nonlinear relationship was also observed between VIM and MTA scores.
The study concluded that greater blood glucose variability, expressed as VIM, was associated with poorer cognitive function as reflected in MMSE and MoCA scores. The relationship between VIM and MTA scores was nonlinear: VIM was positively associated with MTA scores when VIM was below 2.42.
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