Higher glucose levels associated with lower memory and reduced hippocampal microstructure.
LuciaKerti, PhD student
Published January 28, 2014
We thank Drs. Grabenhenrich and Roll for their comments. We reported significant associations of markers of glucose metabolism with memory performance in 141 older adults. [1] In addition to bivariate analyses, we reported adjusted multiple regression models, which were controlled for confounding factors including age and sex using a stepwise selection method. We have now conducted alternative models using the "enter" method for age and sex variables and obtained similar results to those we reported, thus supporting our original conclusions. HbA1c remained significantly associated with the primary outcome (delayed recall) and the other two subtests of memory performance (p less than 0.05). If a Bonferroni correction for multiple testing is applied, the associations between HbA1c and delayed recall and between HbA1c and learning ability remained significant. According to the regression model, a difference in HbA1c levels of 5 mmol/mol was associated with a reduction of 1.4 remembered words [95% CI 0.4 - 2.3] in the delayed recall task. Within our article, we outlined strengths and weaknesses of a cross-sectional design and highlighted the necessity of future longitudinal trials. A recent epidemiologic survey of glucose levels and dementia revealed that higher glucose levels may be a risk factor for dementia, even in persons without diabetes. [2]
1. Kerti L, Witte AV et al. Higher glucose levels associated withlower memory and reduced hippocampal microstructure. Neurology 2013;81:
1746-1752.
2. Crane PK, Walker R, Hubbard RA, et al. Glucose levels and risk of dementia. N Engl J Med 2013;369:540-548.
For disclosures, contact the editorial office at journal@neurology.org.
We thank Drs. Grabenhenrich and Roll for their comments. We reported significant associations of markers of glucose metabolism with memory performance in 141 older adults. [1] In addition to bivariate analyses, we reported adjusted multiple regression models, which were controlled for confounding factors including age and sex using a stepwise selection method. We have now conducted alternative models using the "enter" method for age and sex variables and obtained similar results to those we reported, thus supporting our original conclusions. HbA1c remained significantly associated with the primary outcome (delayed recall) and the other two subtests of memory performance (p less than 0.05). If a Bonferroni correction for multiple testing is applied, the associations between HbA1c and delayed recall and between HbA1c and learning ability remained significant. According to the regression model, a difference in HbA1c levels of 5 mmol/mol was associated with a reduction of 1.4 remembered words [95% CI 0.4 - 2.3] in the delayed recall task. Within our article, we outlined strengths and weaknesses of a cross-sectional design and highlighted the necessity of future longitudinal trials. A recent epidemiologic survey of glucose levels and dementia revealed that higher glucose levels may be a risk factor for dementia, even in persons without diabetes. [2]
1. Kerti L, Witte AV et al. Higher glucose levels associated withlower memory and reduced hippocampal microstructure. Neurology 2013;81: 1746-1752.
2. Crane PK, Walker R, Hubbard RA, et al. Glucose levels and risk of dementia. N Engl J Med 2013;369:540-548.
For disclosures, contact the editorial office at journal@neurology.org.