Objective: To examine the relationships between diabetes control, cognitive function, and family support among middle-aged and older Hispanics/Latinos.
Methods: The Hispanic Community Health Study/Study of Latinos is a population-based study of Hispanic/Latino adults living in 4 U.S. communities. The Digit Symbol Substitution Test (DSST), Word Fluency (WF), and the Spanish English Verbal Learning Test (SEVLT) were administered to 1,454 adults aged 45-74 years with treated diabetes. In addition, an executive function index was derived by combining DSST and WF. Inadequate glycemic control (HbA1c≥7%) was compared across quartiles of cognitive function using multivariable logit models with interaction terms for cognitive function and family support (≤6(median) close relatives was defined as low family support).
Results: Lower DSST scores were associated with HbA1c≥7% (P=0.015). Family support modified the relationship between cognition and diabetic control (pinteraction<0.001 to <0.1). Among low family support individuals, lower cognitive scores were associated with increased odds of inadequate glycemic control (Ptrend across quartiles, 0.006-0.07). Likewise, the association between family support and glycemic control was modified by executive functioning. Among the lowest executive function group, high family support was associated with lower odds of uncontrolled diabetes (OR: 0.46; 95% CI: 0.23, 0.89). However, in individuals with high executive functioning, high family support was associated with higher odds of HbA1c≥7% (OR: 3.09; 95% CI: 1.66, 5.74).
Conclusions: Family support may buffer negative association between low cognitive functioning and diabetes control in Hispanics. Educational programs targeted at family members of middle-age and older persons with diabetes regardless of neurocognitive status may help improve population-level glycemic control.