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Relationship between baseline glycemic control and cognitive function in individuals with type 2 diabetes and other cardiovascular risk factors: the action to control cardiovascular risk in diabetes-memory in diabetes (ACCORD-MIND) trial


Cukierman-Yaffe, Tali, Gerstein, Hertzel C., Williamson, Jeff D., Lazar, Ronald M., Lovato, Laura, Miller, Michael E., Coker, Laura H., Murray, Anne, Sullivan, Mark D., Marcovina, Santica M., Launer, Lenore J.


Diabetes Care, Volume: 32, No.: 2, Pages.: 221-226

Year of Publication



Objective: Diabetes is associated with cognitive decline and dementia. However, the relationship between the degree of hyperglycemia and cognitive status remains unclear. This was explored using baseline cognitive measures collected in the ongoing Memory in Diabetes (MIND) substudy of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial.; Research Design and Methods: The relationship of A1C and fasting plasma glucose (FPG) levels to performance on four cognitive tests was assessed, adjusting for age and other determinants of cognitive status. The tests were the Digit Symbol Substitution Test (DSST), Mini Mental Status Examination (MMSE), Rey Auditory Verbal Learning Test, and Stroop Test.; Results: A statistically significant age-adjusted association was observed between the A1C level and the score on all four cognitive tests. Specifically, a 1% higher A1C value was associated with a significant 1.75-point lower DSST score (95% CI -1.22 to -2.28; P < 0.0001), a 0.20-point lower MMSE score (-0.11 to -0.28; P < 0.0001), a 0.11-point lower memory score (-0.02 to -0.19, P = 0.0142), and a worse score (i.e., 0.75 s more) on the Stroop Test (1.31-0.19, P = 0.0094). The association between the DSST score and A1C persisted in all multiple linear regression models. FPG was not associated with test performance.; Conclusions: Higher A1C levels are associated with lower cognitive function in individuals with diabetes. The effect of glucose lowering on cognitive function will be determined by the ongoing ACCORD-MIND trial.;

Bibtex Citation

@article{Cukierman_Yaffe_2009, doi = {10.2337/dc08-1153}, url = {}, year = 2009, month = {jan}, publisher = {American Diabetes Association}, volume = {32}, number = {2}, pages = {221--226}, author = {T. Cukierman-Yaffe and H. C. Gerstein and J. D. Williamson and R. M. Lazar and L. Lovato and M. E. Miller and L. H. Coker and A. Murray and M. D. Sullivan and S. M. Marcovina and L. J. Launer}, title = {Relationship Between Baseline Glycemic Control and Cognitive Function in Individuals With Type 2 Diabetes and Other Cardiovascular Risk Factors: The Action to Control Cardiovascular Risk in Diabetes-Memory in Diabetes ({ACCORD}-{MIND}) trial}, journal = {Diabetes Care} }


blood, blood glucose, cardiovascular diseases, cognition, complications, diabetes mellitus type 2, diabetic angiopathies, epidemiology, female, hemoglobin a glycosylated, humans, male, memory, mental status schedule, metabolism, middle aged, psychological tests, psychology, regression analysis, reproducibility of results

Countries of Study


Types of Dementia

Dementia (general / unspecified)

Types of Study

Correlation Study (also known as Ecological Study)

Type of Outcomes


Type of Interventions

Risk Factor Modification

Risk Factor Modifications

At risk population