HbA1c stability tied to lower risk for Alzheimer’s disease and related dementias

Increased glycated hemoglobin (HbA1c) stability within patient-specific target ranges is associated with a lower risk for Alzheimer’s disease and related dementias (ADRD), according to a study published online Aug. 2 in JAMA Network Open.

Patricia C. Underwood, Ph.D., from the William F. Connell School of Nursing at Boston College, and colleagues examined the association between HbA1c time in range (TIR) and the incidence of ADRD in older veterans with diabetes. The analysis included 374,021 veterans with diabetes identified from administrative health care data (2005 to 2014) and followed for up to 10 years.

The researchers found that lower HbA1c TIR was associated with an increased risk for incident ADRD (HbA1c TIR of 0 to <20% versus ≥80%: hazard ratio, 1.193). The direction of out-of-range HbA1c levels was also associated with incident ADRD. Having greater time below range was associated with a significantly increased risk (hazard ratio, 1.23). When excluding individuals with baseline use of medications associated with hypoglycemia risk (e.g., insulin and sulfonylureas) or hypoglycemia events, findings remained significant.

“These results affirm the benefits of applying personalized HbA1c target ranges based on age, life expectancy, and comorbidities,” the authors write. “Clinicians should work with patients to ensure HbA1c stability to reduce ADRD risk in older adults with diabetes.”

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