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Association of Prediabetes and Type 2 Diabetes With Cognitive Function After Stroke: A STROKOG Collaboration Study


Background and Purpose- Type 2 diabetes mellitus (T2D) is associated with cognitive impairment and an increased risk of dementia, but the association between prediabetes and cognitive impairment is less clear, particularly in a setting of major cerebrovascular events. This article examines the impact of impaired fasting glucose and T2D on cognitive performance in a stroke population. Methods- Seven international observational studies from the STROKOG (Stroke and Cognition) consortium (n=1601; mean age, 66.0 years; 70% Asian, 26% white, and 2.6% African American) were included. Fasting glucose level (FGL) during hospitalization was used to define 3 groups, T2D (FGL >/=7.0 mmol/L), impaired fasting glucose (FGL 6.1-6.9 mmol/L), and normal (FGL <6.1 mmol/L), and a history of diabetes mellitus and the use of a diabetes mellitus medication were also used to support a diagnosis of T2D. Domain and global cognition Z scores were derived from standardized neuropsychological test scores. The cross-sectional association between glucose status and cognitive performance at 3 to 6 months poststroke was examined using linear mixed models, adjusting for age, sex, education, stroke type, ethnicity, and vascular risk factors. Results- Patients with T2D had significantly poorer performance in global cognition (SD, -0.59 [95% CI, -0.82 to -0.36]; P<0.001) and in all domains compared with patients with normal FGL. There was no significant difference between impaired fasting glucose patients and those with normal FGL in global cognition (SD, -0.10 [95% CI, -0.45 to 0.24]; P=0.55) or in any cognitive domain. Conclusions- Diabetes mellitus, but not prediabetes, is associated with poorer cognitive performance in patients 3 to 6 months after stroke.

Type Journal
ISBN 1524-4628 (Electronic) 0039-2499 (Linking)
Authors Lo, J. W.; Crawford, J. D.; Samaras, K.; Desmond, D. W.; Kohler, S.; Staals, J.; Verhey, F. R. J.; Bae, H. J.; Lee, K. J.; Kim, B. J.; Bordet, R.; Cordonnier, C.; Dondaine, T.; Mendyk, A. M.; Lee, B. C.; Yu, K. H.; Lim, J. S.; Kandiah, N.; Chander, R. J.; Yatawara, C.; Lipnicki, D. M.; Sachdev, P. S.; Collaboration*, Strokog
Responsible Garvan Author Prof Katherine Samaras
Publisher Name STROKE
Published Date 2020-06-01
Published Volume 51
Published Issue 6
Published Pages 1640-1646
Status Published in-print
DOI 10.1161/STROKEAHA.119.028428
URL link to publisher's version