dc.description.abstract
Impulsivity has been proposed to have an impact on glycemic dysregulation. However, it remains uncertain whether an unfavorable glycemic status could also contribute to an increase in impulsivity levels. This study aims to analyze associations of baseline and time-varying glycemic status with 3-year time-varying impulsivity in older adults at high risk of cardiovascular disease. A 3-year prospective cohort design was conducted within the PREDIMED-Plus-Cognition substudy. The total population includes 487 participants (mean age = 65.2 years; female = 50.5%) with overweight or obesity and metabolic syndrome. Insulin resistance (HOMA-IR), glycated hemoglobin (HbA1c), presence of type 2 diabetes mellitus, and type 2 diabetes control were evaluated. Impulsivity was measured using the Impulsive Behavior Scale questionnaire and various cognitive measurements. Impulsivity z-scores were generated to obtain Global, Trait, and Behavioral Impulsivity domains. Linear mixed models were used to study the longitudinal associations across baseline, 1-year, and 3-year follow-up visits. HOMA-IR was not significantly related to impulsivity. Participants with higher HbA1c levels, type 2 diabetes, and poor control of diabetes showed positive associations with the Global Impulsivity domain over time, and those with higher HbA1c levels were further related to increases in the Trait and Behavioral Impulsivity domains over the follow-up visits. These results suggest a potential positive feedback loop between impulsivity and glycemic-related dysregulation.
dc.description.abstract
We thank the PREDIMED-Plus participants and staff members for their participation, as well as the primary care centers that took part in the study. Furthermore, we thank the CERCA Program of the Generalitat de Catalunya and the CIBEROBN, CIBERESP, and CIBERDEM initiatives of Instituto de Salud Carlos III in Spain. This work was supported by the official Spanish Institutions for funding scientific biomedical research, CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN) and Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigación para la Salud (FIS), which is cofunded by the European Regional Development Fund (six coordinated FIS projects leaded by J.S.-S., including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01133, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01306, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01130, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01326, PI19/00781, PI19/01560, PI19/01332, PI20/01802, PI20/00138, PI20/01532, PI20/00456, PI20/00339, PI20/00557, PI20/00886, PI20/01158; the Especial Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to J.S.-S.; the Recercaixa (number 2013ACUP00194) grant to J.S.-S.; grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, PI0137/2018); the PROMETEO/2017/017 and PROMETEO/21/2021 grants from the Generalitat Valenciana, and the grant PID2019-108858RB-I00 funded by AEI 10.13039/501100011033 and by “ERDF A way of making Europe” to D.C.; the APOSTD2020-164 from the Generalitat Valenciana to A.A.-S.; the SEMERGEN grant; C.G.-M. receives a predoctoral grant from the University of Rovira i Virgili (2020PMF-PIPF-37); J.S.-S., senior author of this paper, is partially supported by ICREA under the ICREA Academia program; L.C.-B. was supported by Sara Borrell fellowship CD22/00171 funded by the Instituto de Salud Carlos III (ISCIII) and cofounded by the European Union; J.J. holds the Miguel Servet-II contract (CPII19/00015) awarded by the Instituto de Salud Carlos III (cofunded by the European Social Fund “Investing in your future”). S.K.N. was supported by a postdoctoral fellowship from the Canadian Institutes of Health Research (CIHR, MFE-171207). F.F.-A. obtained from Generalitat de Catalunya the 2021 SGR 00824 grant, and from Instituto de Salud Carlos II the FORT23/00032 and the PI20/132 grants. None of the funding sources took part in the design, collection, analysis, interpretation of the data, or writing the report, or in the decision to submit the manuscript for publication. We thank CERCA Programme/Generalitat de Catalunya for institutional support and partial support was also provided by SLT006/17/00246, funded by the Department of Health of the Generalitat de Catalunya by the calls “Acció instrumental de programes de recerca orientats en l’àmbit de la recerca i la innovació en salut” and “Pla estratègic de recerca i innovació en salut (PERIS).” This research was also partially funded by EU-H2020 Grants (Eat2beNICE/ H2020-SFS-2016-2, Ref 728018; and PRIME/ H2020-SC1-BHC-2018-2020, Ref: 847879).
