OBJECTIVE Hispanics/Latinos in the United States have the highest prevalence of undiagnosed and untreated diabetes and are at increased risk for cognitive impairment. In this study, we examine glycemic control in relation to cognitive aging and impairment in a large prospective cohort of middle-aged and older Hispanics/Latinos of diverse heritages. RESEARCH DESIGN AND METHODS Study of Latinos–Investigation of Neurocognitive Aging (SOL-INCA) is a Hispanic Community Health Study/Study of Latinos (HCHS/SOL) ancillary study. HCHS/SOL is a multisite (Bronx, NY; Chicago, IL; Miami, FL; and San Diego, CA), probability sampled prospective cohort study. SOL-INCA enrolled 6,377 diverse Hispanics/Latinos age 50 years and older (2016–2018). The primary outcomes were cognitive function, 7-year cognitive decline and mild cognitive impairment (MCI). The primary glycemia exposure variables were measured from fasting blood samples collected at HCHS/SOL visit 1 (2008–2011). RESULTS Visit 1 mean age was 56.5 years ± 8.2 SD, and the average glycosylated hemoglobin A1C (HbA1c) was 6.12% (43.5 ± 14.6 mmol/mol). After covariates adjustment, higher HbA1c was associated with accelerated 7-year global (b = −0.045; 95% CI = −0.070; −0.021; in z-score units) and executive cognitive decline, and a higher prevalence of MCI (odds ratio = 1.20; 95% CI = 1.11;1.29). CONCLUSIONS Elevated HbA1c levels were associated with 7-year executive cognitive decline and increased MCI risk among diverse middle-aged and older Hispanics/Latinos. Our findings indicate that poor glycemic control in midlife may pose significant risks for cognitive decline and MCI later in life among Hispanics/Latinos of diverse heritages.

中文翻译：

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不同西班牙裔/拉丁裔的血糖控制、认知老化和损伤：拉丁裔研究——神经认知老化调查（西班牙裔社区健康研究/拉丁裔研究）

目标 在美国，西班牙裔/拉丁裔未确诊和未治疗的糖尿病患病率最高，并且认知障碍的风险较高。在这项研究中，我们在一大群具有不同血统的中年和老年西班牙裔/拉丁裔前瞻性队列中研究了血糖控制与认知衰老和认知障碍之间的关系。研究设计和方法 拉丁裔研究 - 神经认知老化调查 (SOL-INCA) 是一项西班牙裔社区健康研究/拉丁裔研究 (HCHS/SOL) 辅助研究。 HCHS/SOL 是一项多地点（纽约州布朗克斯、伊利诺伊州芝加哥、佛罗里达州迈阿密和加利福尼亚州圣地亚哥）概率抽样前瞻性队列研究。 SOL-INCA 招募了 6,377 名年龄在 50 岁及以上的不同西班牙裔/拉丁裔人士（2016-2018 年）。主要结局是认知功能、7 年认知能力下降和轻度认知障碍 (MCI)。主要血糖暴露变量是通过 HCHS/SOL 访视 1（2008-2011）收集的空腹血样测量的。结果 第 1 次访视的平均年龄为 56.5 岁 ± 8.2 SD，平均糖化血红蛋白 A1C (HbA1c) 为 6.12% (43.5 ± 14.6 mmol/mol)。协变量调整后，较高的 HbA1c 与 7 年总体加速（b = -0.045；95% CI = -0.070；-0.021；以 z 分数单位表示）和执行认知能力下降以及 MCI 患病率较高相关（比值比= 1.20；95% CI = 1.11；1.29)。结论 HbA1c 水平升高与不同中年和老年西班牙裔/拉丁裔人的 7 年执行认知能力下降以及 MCI 风险增加相关。我们的研究结果表明，中年时期血糖控制不佳可能会对不同血统的西班牙裔/拉丁裔人造成晚年认知能力下降和 MCI 的重大风险。