Glycemic control, cognitive function, and family support among middle-aged and older Hispanics with diabetes: The Hispanic Community Health Study/Study of Latinos

Garrett Strizich; Robert C. Kaplan; Hector M. González; Martha L. Daviglus; Aida L. Giachello; Yanping Teng; Richard B. Lipton; Ellen Grober

doi:10.1016/j.diabres.2016.04.052

Glycemic control, cognitive function, and family support among middle-aged and older Hispanics with diabetes: The Hispanic Community Health Study/Study of Latinos

Garrett Strizich^*, Robert C. Kaplan, Hector M. González, Martha L. Daviglus, Aida L. Giachello, Yanping Teng, Richard B. Lipton, Ellen Grober

^*Corresponding author for this work

Preventive Medicine

Research output: Contribution to journal › Article › peer-review

22 Scopus citations

Abstract

Aims: To examine among Hispanics in the U.S., a population with increased reliance on informal healthcare support structures, (1) the association between cognitive function and control of diabetes; and (2) whether this association is modified by family support. Methods: The Digit Symbol Substitution Test (DSST), word fluency, and learning and delayed recall components of the Spanish English Verbal Learning Test were administered to 1794 Hispanic adults aged 45-76 years with diagnosed diabetes. An executive function index and global cognitive function index (GCFI) were derived. Uncontrolled diabetes (HbA1c ≥ 7% [53 mmol/mol]) was compared across quartiles of cognitive function using multivariable logit models with interaction terms for cognitive function and family support. Results: After adjustment, lower DSST scores were associated with uncontrolled diabetes (P = 0.03). Family support modified the relationship between other measures of cognition and diabetes control (P_interaction: 0.002, 0.09). Among individuals with low family support, as cognitive function declined, the odds of uncontrolled diabetes increased (P-trend across quartiles of the GCFI, 0.015). Among those with low family support, persons in the lowest quartile of global cognitive function were more than twice as likely to have uncontrolled diabetes as those in the highest performing quartile (OR = 2.31; 95% CI: 1.17, 4.55). There was no similar effect among those with high family support. Conclusions: Family support may buffer the negative association between low cognitive functioning and diabetes control in US Hispanics/Latinos. Educational programs targeted at family members of middle-age and older persons with diabetes regardless of neurocognitive status may help improve population-level glycemic control.

Original language	English (US)
Pages (from-to)	64-73
Number of pages	10
Journal	Diabetes Research and Clinical Practice
Volume	117
DOIs	https://doi.org/10.1016/j.diabres.2016.04.052
State	Published - Jul 1 2016

Funding

The Hispanic Community Health Study/Study of Latinos was carried out as a collaborative study supported by contracts from the National Heart, Lung, and Blood Institute (NHLBI) to the University of North Carolina (N01-HC65233), University of Miami (N01-HC65234), Albert Einstein College of Medicine (N01-HC65235), Northwestern University (N01-HC65236), and San Diego State University (N01-HC65237). The following Institutes/Centers/Offices contribute to the HCHS/SOL through a transfer of funds to the NHLBI: National Center on Minority Health and Health Disparities, the National Institute of Deafness and Other Communications Disorders, the National Institute of Dental and Craniofacial Research, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Neurological Disorders and Stroke, and the Office of Dietary Supplements. Drs. Daviglus, Gonzalez, Kaplan, and Lipton also received funding from the National Institute on Aging (R01-AG48642).

Keywords

Cognitive function
Diabetes
Glycemic control
Hispanic
Social support

ASJC Scopus subject areas

Internal Medicine
Endocrinology, Diabetes and Metabolism
Endocrinology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.diabres.2016.04.052

Cite this

Strizich, G., Kaplan, R. C., González, H. M., Daviglus, M. L., Giachello, A. L., Teng, Y., Lipton, R. B., & Grober, E. (2016). Glycemic control, cognitive function, and family support among middle-aged and older Hispanics with diabetes: The Hispanic Community Health Study/Study of Latinos. Diabetes Research and Clinical Practice, 117, 64-73. https://doi.org/10.1016/j.diabres.2016.04.052

@article{8f94816975f7486d811aca42c1af07ae,

title = "Glycemic control, cognitive function, and family support among middle-aged and older Hispanics with diabetes: The Hispanic Community Health Study/Study of Latinos",

abstract = "Aims: To examine among Hispanics in the U.S., a population with increased reliance on informal healthcare support structures, (1) the association between cognitive function and control of diabetes; and (2) whether this association is modified by family support. Methods: The Digit Symbol Substitution Test (DSST), word fluency, and learning and delayed recall components of the Spanish English Verbal Learning Test were administered to 1794 Hispanic adults aged 45-76 years with diagnosed diabetes. An executive function index and global cognitive function index (GCFI) were derived. Uncontrolled diabetes (HbA1c ≥ 7% [53 mmol/mol]) was compared across quartiles of cognitive function using multivariable logit models with interaction terms for cognitive function and family support. Results: After adjustment, lower DSST scores were associated with uncontrolled diabetes (P = 0.03). Family support modified the relationship between other measures of cognition and diabetes control (Pinteraction: 0.002, 0.09). Among individuals with low family support, as cognitive function declined, the odds of uncontrolled diabetes increased (P-trend across quartiles of the GCFI, 0.015). Among those with low family support, persons in the lowest quartile of global cognitive function were more than twice as likely to have uncontrolled diabetes as those in the highest performing quartile (OR = 2.31; 95% CI: 1.17, 4.55). There was no similar effect among those with high family support. Conclusions: Family support may buffer the negative association between low cognitive functioning and diabetes control in US Hispanics/Latinos. Educational programs targeted at family members of middle-age and older persons with diabetes regardless of neurocognitive status may help improve population-level glycemic control.",

keywords = "Cognitive function, Diabetes, Glycemic control, Hispanic, Social support",

author = "Garrett Strizich and Kaplan, {Robert C.} and Gonz{\'a}lez, {Hector M.} and Daviglus, {Martha L.} and Giachello, {Aida L.} and Yanping Teng and Lipton, {Richard B.} and Ellen Grober",

note = "Publisher Copyright: {\textcopyright} 2016 Elsevier Ireland Ltd.",

year = "2016",

month = jul,

day = "1",

doi = "10.1016/j.diabres.2016.04.052",

language = "English (US)",

volume = "117",

pages = "64--73",

journal = "Diabetes Research and Clinical Practice",

issn = "0168-8227",

publisher = "Elsevier Ireland Ltd",

}

Strizich, G, Kaplan, RC, González, HM, Daviglus, ML, Giachello, AL, Teng, Y, Lipton, RB & Grober, E 2016, 'Glycemic control, cognitive function, and family support among middle-aged and older Hispanics with diabetes: The Hispanic Community Health Study/Study of Latinos', Diabetes Research and Clinical Practice, vol. 117, pp. 64-73. https://doi.org/10.1016/j.diabres.2016.04.052

Glycemic control, cognitive function, and family support among middle-aged and older Hispanics with diabetes: The Hispanic Community Health Study/Study of Latinos. / Strizich, Garrett; Kaplan, Robert C.; González, Hector M. et al.
In: Diabetes Research and Clinical Practice, Vol. 117, 01.07.2016, p. 64-73.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Glycemic control, cognitive function, and family support among middle-aged and older Hispanics with diabetes

T2 - The Hispanic Community Health Study/Study of Latinos

AU - Strizich, Garrett

AU - Kaplan, Robert C.

AU - González, Hector M.

AU - Daviglus, Martha L.

AU - Giachello, Aida L.

AU - Teng, Yanping

AU - Lipton, Richard B.

AU - Grober, Ellen

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Aims: To examine among Hispanics in the U.S., a population with increased reliance on informal healthcare support structures, (1) the association between cognitive function and control of diabetes; and (2) whether this association is modified by family support. Methods: The Digit Symbol Substitution Test (DSST), word fluency, and learning and delayed recall components of the Spanish English Verbal Learning Test were administered to 1794 Hispanic adults aged 45-76 years with diagnosed diabetes. An executive function index and global cognitive function index (GCFI) were derived. Uncontrolled diabetes (HbA1c ≥ 7% [53 mmol/mol]) was compared across quartiles of cognitive function using multivariable logit models with interaction terms for cognitive function and family support. Results: After adjustment, lower DSST scores were associated with uncontrolled diabetes (P = 0.03). Family support modified the relationship between other measures of cognition and diabetes control (Pinteraction: 0.002, 0.09). Among individuals with low family support, as cognitive function declined, the odds of uncontrolled diabetes increased (P-trend across quartiles of the GCFI, 0.015). Among those with low family support, persons in the lowest quartile of global cognitive function were more than twice as likely to have uncontrolled diabetes as those in the highest performing quartile (OR = 2.31; 95% CI: 1.17, 4.55). There was no similar effect among those with high family support. Conclusions: Family support may buffer the negative association between low cognitive functioning and diabetes control in US Hispanics/Latinos. Educational programs targeted at family members of middle-age and older persons with diabetes regardless of neurocognitive status may help improve population-level glycemic control.

AB - Aims: To examine among Hispanics in the U.S., a population with increased reliance on informal healthcare support structures, (1) the association between cognitive function and control of diabetes; and (2) whether this association is modified by family support. Methods: The Digit Symbol Substitution Test (DSST), word fluency, and learning and delayed recall components of the Spanish English Verbal Learning Test were administered to 1794 Hispanic adults aged 45-76 years with diagnosed diabetes. An executive function index and global cognitive function index (GCFI) were derived. Uncontrolled diabetes (HbA1c ≥ 7% [53 mmol/mol]) was compared across quartiles of cognitive function using multivariable logit models with interaction terms for cognitive function and family support. Results: After adjustment, lower DSST scores were associated with uncontrolled diabetes (P = 0.03). Family support modified the relationship between other measures of cognition and diabetes control (Pinteraction: 0.002, 0.09). Among individuals with low family support, as cognitive function declined, the odds of uncontrolled diabetes increased (P-trend across quartiles of the GCFI, 0.015). Among those with low family support, persons in the lowest quartile of global cognitive function were more than twice as likely to have uncontrolled diabetes as those in the highest performing quartile (OR = 2.31; 95% CI: 1.17, 4.55). There was no similar effect among those with high family support. Conclusions: Family support may buffer the negative association between low cognitive functioning and diabetes control in US Hispanics/Latinos. Educational programs targeted at family members of middle-age and older persons with diabetes regardless of neurocognitive status may help improve population-level glycemic control.

KW - Cognitive function

KW - Diabetes

KW - Glycemic control

KW - Hispanic

KW - Social support

UR - http://www.scopus.com/inward/record.url?scp=84968884385&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84968884385&partnerID=8YFLogxK

U2 - 10.1016/j.diabres.2016.04.052

DO - 10.1016/j.diabres.2016.04.052

M3 - Article

C2 - 27329024

AN - SCOPUS:84968884385

SN - 0168-8227

VL - 117

SP - 64

EP - 73

JO - Diabetes Research and Clinical Practice

JF - Diabetes Research and Clinical Practice

ER -

Glycemic control, cognitive function, and family support among middle-aged and older Hispanics with diabetes: The Hispanic Community Health Study/Study of Latinos

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this