Glycemic control, inflammation, and cognitive function in older patients with type 2 diabetes

Jimmy Akrivos*, Ramit Ravona-Springer, James Schmeidler, Derek Leroith, Anthony Heymann, Rachel Preiss, Hadas Hoffman, Keren Koifman, Jeremy M. Silverman, Michal Schnaider Beeri

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective Glycated hemoglobin (HbA1c) and C-reactive protein (CRP) have been associated with cognitive impairment independently. However, it is unclear if their combination exacerbates poor cognitive function. We assessed whether long-term glycemic level and glycemic variability modulate the association of systemic inflammation with cognitive function, in a sample of cognitively normal older people with type 2 diabetes. Methods A retrospective cohort study of 777 randomly selected participants from ~11,000 patients in the Maccabi Healthcare Services Diabetes Registry, as part of the Israel Diabetes and Cognitive Decline study. Subjects averaged 18 (±9.4) HbA1c measures in the Maccabi Healthcare Services Registry, which were used to calculate long-term glycemic level (HbA1c-mean) and glycemic variability (HbA1c-standard deviation (SD)). Linear regression models assessed the interactions of CRP, a marker of systemic inflammation, with HbA1c-mean and HbA1c-SD on subjects' performance in tests of Memory, Executive Functions, Attention, and Semantic Categorization. Results Quadratic interactions of CRP with HbA1c-SD approached significance for executive functions and overall cognition. However, after Bonferroni adjustment, none of the interactions of CRP with HbA1c were statistically significant. In partial correlations according to HbA1c-SD tertiles, CRP was weakly correlated in the middle tertile with decreased performance in the domains of semantic categorization (r = -0.166, p = 0.011), executive functions (r = -0.136, p = 0.038), and overall cognition (r = -0.157, p = 0.016). Conclusions Glycated hemoglobin does not substantially modulate the association of CRP with cognition in a sample of cognitively normal, community dwelling older people with relatively well-managed type 2 diabetes.

Original languageEnglish
Pages (from-to)1093-1100
Number of pages8
JournalInternational Journal of Geriatric Psychiatry
Issue number10
StatePublished - 1 Oct 2015
Externally publishedYes


  • C-reactive protein
  • HbA1c
  • cognitive function
  • older people
  • type 2 diabetes


Dive into the research topics of 'Glycemic control, inflammation, and cognitive function in older patients with type 2 diabetes'. Together they form a unique fingerprint.

Cite this