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Methods

Data from wave 2 (2004–2005) to wave 7 (2014–2015) of the English Longitudinal Study of Ageing (ELSA) were analysed. Cognitive function was assessed at baseline (wave 2) and reassessed every 2 years at waves 3–7. Linear mixed models were used to evaluate longitudinal associations.

Results

The study comprised 5189 participants (55.1% women, mean age 65.6±9.4 years) with baseline HbA 1c levels ranging from 15.9 to 126.3 mmol/mol (3.6–13.7%). The mean follow-up duration was 8.1±2.8 years and the mean number of cognitive assessments was 4.9±1.5. A 1 mmol/mol increment in HbA 1c was significantly associated with an increased rate of decline in global cognitive z scores (− 0.0009 SD/year, 95% CI− 0.0014,− 0.0003), memory z scores (− 0.0005 SD/year, 95% CI− 0.0009,− 0.0001) and executive function z scores (− 0.0008 SD/year, 95% CI− 0.0013,− 0.0004) after adjustment for …