Glycated hemoglobin A1c and cognitive impairment in complex chronic patients: A cross-sectional study.

Objective: This study examines the relationship between Glycated hemoglobin A1c (HbA1c) levels and cognitive impairment in elderly patients with complex chronic conditions, a link previously unclear.

Design: This is a cross-sectional study.

Material and methods: The data from 2,366 patients in Catalonia (2013-2017) from the Dryad database. HbA1c levels were taken from clinical records, and cognitive function was assessed with ICD-10 criteria and the Pfeiffer test. We included demographic details, comorbidities, medications, and clinical data as covariates. Multivariate logistic regression was used, with subgroup analyses by age and other factors.

Results: The cohort had an average age of 84.1 ± 10 years; 46.4% were male, with an average HbA1c of 6.5 ± 1.4%. Cognitive impairment was present in 20.2% of participants. The association between HbA1c and cognitive impairment was not significant after adjusting for all variables (OR = 0.99, 95% CI: 0.91-1.08, p > 0.05). Ischemic cardiomyopathy (p = 0.008) and Barthel scores > 40 (p = 0.032) demonstrate an interaction effect on their relationship.

Conclusion: In the population of patients with complex chronic conditions, HbA1c did not show a statistically significant correlation with cognitive impairment, indicating that HbA1c might not be an independent predictor of cognitive decline in this group, though further research is needed to confirm this.