Cognitive decline is related to high blood glucose levels in older Chinese adults with the ApoE ϵ3/ϵ3 genotype

Abstract

Background: Few studies have investigated the effects of blood glucose (BG) on cognitive function in community-dwelling elderly individuals carrying the apolipoprotein E (APOE) ϵ3 allele. Objective: To explore the effect of high BG levels on cognitive function in APOE ϵ3-carrying, non-demented, community-dwelling older adults, as compared to their counterparts carrying the APOE ϵ4 or APOE ϵ2 alleles. Methods: Within the China Longitudinal Ageing Study, we recruited 282 elderly adults without dementia. Data collected included demographic information; psychological measures; laboratory test results, including BG and plasma lipid levels; and APOE genotypes. We divided the participants into APOE ϵ2(ϵ2/ϵ2, ϵ2/ϵ3), ϵ3(ϵ3/ϵ3), and ϵ4(ϵ3/ϵ4, ϵ4/ϵ4) groups. Partial correlation analyses and multivariate linear regression analyses were utilized to compare the cognitive function and laboratory data between the APOE groups. White matter hyperintensity (WMH) was measured on magnetic resonance images in 77 participants. Results: With adjustment for age, sex, education, and diabetes, higher BG in non-demented community-dwelling older adults was associated with cognitive decline in immediate memory and executive function. In the APOE ϵ3 group, elevated BG was associated with cognitive decline in immediate memory, executive function, and perceptual reasoning. In the APOE ϵ4 group, higher BG was also correlated with a decline in abstract reasoning. There was a trend for association between higher BG and more severe WMHs. Conclusion: Worse cognitive function was correlated withApoEϵ3/ϵ3 genotype carriers with higher BG in community-dwelling older adults.