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Article ; Online: Association of insomnia with incident chronic cognitive impairment in older adults with type 2 diabetes mellitus: A prospective study of the Hong Kong Diabetes Register.

O, Chun-Kwan / Siu, Brian Wai-Hei / Leung, Vanessa Wai-Shan / Lin, Yuan-Yuan / Ding, Chen-Zhao / Lau, Eric Siu-Him / Luk, Andrea On-Yan / Chow, Elaine Yee-Kwan / Ma, Ronald Ching-Wan / Chan, Juliana Chung-Ngor / Chan, Rachel Ngan-Yin / Wing, Yun Kwok / Kong, Alice Pik-Shan

Journal of diabetes and its complications

2023  Volume 37, Issue 10, Page(s) 108598

Abstract: Aims: To examine the risk association of insomnia with incident chronic cognitive impairment in older adults with type 2 diabetes mellitus (T2D).: Methods: Between July 2010 and June 2015, patients with T2D aged ≥60 years enrolled in the Hong Kong ... ...

Abstract Aims: To examine the risk association of insomnia with incident chronic cognitive impairment in older adults with type 2 diabetes mellitus (T2D).
Methods: Between July 2010 and June 2015, patients with T2D aged ≥60 years enrolled in the Hong Kong Diabetes Register completed the Insomnia Severity Index (ISI) questionnaire. Patients were considered having insomnia if they had ISI score > 14. We prospectively followed up the cohort and censored outcome through reviewing diagnoses and clinical notes entered by attending physicians in electronic medical record to identify incident cases of mild cognitive impairment and dementia.
Results: After excluding shift workers and those with established chronic cognitive impairment at baseline, we included 986 patients with T2D in this study (58.3 % men, mean age ± standard deviation: 62.5 ± 2.6 years, disease duration of diabetes: 10.7 ± 8.2 years, HbA1c: 7.4 ± 1.3 %, insulin users: 28.7 %, insomnia: 9.1 %). After a median follow-up of 7.6 (interquartile range = 2.0) years, 41 (4.2 %) developed chronic cognitive impairment. Using Cox regression analysis, insomnia (hazard ratio, HR 2.909, p = 0.012) and HbA1c ≥ 7 % (HR 2.300, p = 0.038) were positively associated with incident chronic cognitive impairment while insulin use (HR 0.309, p = 0.028) showed negative association.
Conclusions: Insomnia, suboptimal glycemic control and non-insulin use are independent risk factors for incident chronic cognitive impairment in older adults with T2D.
MeSH term(s) Male ; Humans ; Aged ; Female ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/epidemiology ; Prospective Studies ; Glycated Hemoglobin ; Hong Kong/epidemiology ; Sleep Initiation and Maintenance Disorders/complications ; Sleep Initiation and Maintenance Disorders/epidemiology ; Risk Factors ; Cognitive Dysfunction/complications ; Cognitive Dysfunction/epidemiology ; Insulin
Chemical Substances Glycated Hemoglobin ; Insulin
Language English
Publishing date 2023-09-04
Publishing country United States
Document type Journal Article
ZDB-ID 1105840-7
ISSN 1873-460X ; 1056-8727
ISSN (online) 1873-460X
ISSN 1056-8727
DOI 10.1016/j.jdiacomp.2023.108598
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