Locus of Control and Cognition in Older Adults With Type 1 Diabetes

Eng, Chloe W.; Gilsanz, Paola; Lacy, Mary E.; Beeri, Michal Schnaider; Whitmer, Rachel A.

doi:10.1097/wad.0000000000000352

Cited by 4 publications

(5 citation statements)

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“…Our results suggest that individuals with a more internal LOC or conscientious personality were more likely to break the link between ELD and diminished cognitive ability. This is consistent with prior studies finding internal LOC ( Anderson et al., 2018 ; Eng et al., 2020 ; Wight et al., 2003 ) and conscientiousness ( Curtis et al., 2015 ; Low et al., 2013 ; Luchetti et al., 2016 ; Wilson et al., 2007 ) to be related with better cognitive outcomes. Our results also agree with studies finding conscientiousness to be related to cognitive resilience ( Graham et al., 2021 ).…”

Section: Discussionsupporting

confidence: 92%

“…Internal LOC is associated with better cognitive ability ( Anderson et al., 2018 ; Wight et al., 2003 ), and changing from external to internal LOC was more beneficial for cognitive ability than changing to or remaining external ( Anderson et al., 2018 ). An internal LOC has also been associated with better cognitive ability among men, but not women, with type 1 diabetes ( Eng et al., 2020 ). Like conscientiousness, LOC shapes health and health behaviors and how one deal with stress and adversity.…”

Section: Introductionmentioning

confidence: 99%

“…Women tend to have more external LOC, compared to men ( Sherman et al., 1997 ). Associations between LOC and cognitive ability may also differ across gender ( Eng et al., 2020 ). Gender differences in conscientiousness are less clear.…”

Section: Introductionmentioning

confidence: 99%

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Gender, Personality, and Cognitive Resilience Against Early-Life Disadvantage

Sáenz

Milani

Mejía-Arango

2023

The Journals of Gerontology: Series B

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Objectives Early-life disadvantage (ELD) relates with lower late-life cognition. However, personality factors including having an internal locus of control (LOC) or a conscientious personality relate with resilience and effective stress coping. We explore whether personality factors convey resilience against negative effects of ELD on cognition, by gender, in Mexico. Methodology Using the 2015 Mexican Health and Aging Study, we estimated expected cognition using multiple ELD markers to identify a subsample in the lowest quartile of expected cognition given ELD (n=2,086). In this subsample, we estimated cross-sectional associations between personality and having above median observed cognitive ability (n=522) using logistic regression. Results Among those in the lowest quartile of expected cognition, a more internal LOC (β = 0.32 [Men] and β = 0.44 [Women]) and conscientious personality (β = 0.39 [Men] and β = 0.17 [Women]) were significantly associated with having above median cognitive ability in models adjusted for demographic confounders. Larger benefits of conscientiousness were observed for men than women. Associations between personality and having above median cognitive ability remained statistically significant after further adjustment for health, stress, and cognitive stimulation variables, regardless of gender. Discussion Personality factors may convey resilience among individuals who experienced ELD, potentially breaking the link between ELD and worse late-life cognition. Structural factors and gender roles may affect how much women benefit from personality factors.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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Gender, Personality, and Cognitive Resilience Against Early-Life Disadvantage

Sáenz

Milani

Mejía-Arango

2023

The Journals of Gerontology: Series B

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“…In each of these models, we initially fitted base models that adjusted for age and education. We then added diabetes status, race/ethnicity, PSQI and GDS score in a stepwise fashion to explore how these factors, that have been shown to be associated with cognition in this sample, 17 18 influenced any sex-cognitive performance relationship. We then tested a final model including health literacy and cardiovascular health measures (neuropathy, nephropathy, retinopathy, stroke and myocardial infarction).…”

Section: Methodsmentioning

confidence: 99%

“…[16][17][18] Potential participants with T1D were identified in electronic medical records using International Classification of Diseases (ICD)-9 and ICD-10 codes for T1D (250.x1, 250.x3 or E10.x) or T2D (250.x0, 250.x2, E11.x). As per previous work using the SOLID dataset, [16][17][18] individuals with diagnostic codes related to both types of diabetes were classified as having T1D if at least 75% of diagnostic codes related to diabetes were for T1D specifically and the member was prescribed insulin to reduce the risk of misclassification. Enrolled participants with T1D were then used to guide recruitment of two comparator groups: people with T2D and people without either T1D or T2D.…”

Section: Study Populationmentioning

confidence: 99%

Sex, diabetes status and cognition: findings from the study of longevity in diabetes

Moran

Gilsanz

Beeri

et al. 2021

BMJ Open Diab Res Care

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IntroductionWomen comprise two-thirds of people with dementia, making female sex a significant dementia risk factor. Both type 1 diabetes (T1D) and type 2 diabetes (T2D) are known dementia risk factors with an increasing global incidence. Understanding whether subtle sex differences persist in cognitive function prior to dementia in the context of diabetes may help elucidate the magnitude of sex effects on dementia risk.Research design and methodsWe examined cross-sectional data from the Study of Longevity in Diabetes (SOLID), a prospective cohort study of members of Kaiser Permanente Northern California aged 60 years and older with T1D (n=758), T2D (n=232) and without either T1D or T2D (n=247). We used factor analysis to generate summary scores of cognitive domains and used regression analyses to examine the associations between sex and cognition adjusting for sociodemographic and cardiovascular confounders.ResultsWe included 1237 participants (630 women and 607 men) with mean age 68 years. By design, the distribution of men and women in T1D, T2D and no diabetes was similar. Women had better cognitive performance than men in global cognition (β=0.21, 95% CI 0.16 to 0.26), language (β=0.08, 95% CI 0.004 to 0.15), executive function (β=0.13, 95% CI 0.05 to 0.20), episodic verbal memory (β=0.68, 95% CI 0.59 to 0.77) and attention (β=0.20, 95% CI 0.11 to 0.28) but not in episodic visual memory (β=0.006, 95% CI −0.07 to 0.09) adjusting for age and education independent of diabetes status. We did not find an interaction between sex and diabetes status for any of the cognitive outcomes.ConclusionsWomen in late mid-life have better cognitive performance than men in many cognitive domains independent of the presence of T1D or T2D. Further work is required to understand whether these differences change over time or in older cohorts and to understand their relationship to subsequent dementia.

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Discoveries from the study of longstanding type 1 diabetes

et al. 2021

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Award programmes that acknowledge the remarkable accomplishments of long-term survivors with type 1 diabetes have naturally evolved into research programmes to determine the factors associated with survivorship and resistance to chronic complications. In this review, we present an overview of the methodological sources of selection bias inherent in survivorship research (selection of those with early-onset diabetes, incidence-prevalence bias and bias from losses to follow-up in cohort studies) and the breadth and depth of literature focusing on this special study population. We focus on the learnings from the study of longstanding type 1 diabetes on discoveries about the natural history of insulin production loss and microvascular complications, and mechanisms associated with them that may in future offer therapeutic targets. We detail descriptive findings about the prevalence of preserved insulin production and resistance to complications, and the putative mechanisms associated with such resistance. To date, findings imply that the following mechanisms exist: strategies to maintain or recover beta cells and their function; activation of specific glycolytic enzymes such as pyruvate kinase M2; modification of AGE production and processing; novel mechanisms for modification of renin-angiotensin-aldosterone system activation, in particular those that may normalise afferent rather than efferent renal arteriolar resistance; and activation and modification of processes such as retinol binding and DNA damage checkpoint proteins. Among the many clinical and public health insights, research into this special study population has identified putative mechanisms that may in future serve as therapeutic targets, knowledge that likely could not have been gained without studying long-term survivors.

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Locus of Control and Cognition in Older Adults With Type 1 Diabetes

Cited by 4 publications

References 35 publications

Gender, Personality, and Cognitive Resilience Against Early-Life Disadvantage

Gender, Personality, and Cognitive Resilience Against Early-Life Disadvantage

Sex, diabetes status and cognition: findings from the study of longevity in diabetes

Discoveries from the study of longstanding type 1 diabetes

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