Lower verbal intelligence is associated with diabetic complications and slower walking speed in people with Type 2 diabetes: the Maastricht Study

P J J Spauwen, Remy Martens, C D A Stehouwer, F R J Verhey, M T Schram, S J S Sep, C J H van der Kallen, P C Dagnelie, R M A Henry, N C Schaper, M P J van Boxtel*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

AIMS: To determine the association of verbal intelligence, a core constituent of health literacy, with diabetic complications and walking speed in people with Type 2 diabetes.

METHODS: This study was performed in 228 people with Type 2 diabetes participating in the Maastricht Study, a population-based cohort study. We examined the cross-sectional associations of score on the vocabulary test of the Groningen Intelligence Test with: 1) determinants of diabetic complications (HbA1c , blood pressure and lipid level); 2) diabetic complications: chronic kidney disease, neuropathic pain, self-reported history of cardiovascular disease and carotid intima-media thickness; and 3) walking speed. Analyses were performed using linear regression and adjusted in separate models for potential confounders and mediators. Significant age- and sex-adjusted associations were additionally adjusted for educational level in a separate model.

RESULTS: After full adjustment, lower verbal intelligence was associated with the presence of neuropathic pain [odds ratio (OR) 1.18, 95% CI 1.02;1.36], cardiovascular disease (OR 1.14, 95% CI 1.01;1.30), and slower walking speed (regression coefficient -0.011 m/s, 95% CI -0.021; -0.002 m/s). These associations were largely explained by education. Verbal intelligence was not associated with blood pressure, glycaemic control, lipid control, chronic kidney disease or carotid intima-media thickness.

CONCLUSIONS: Lower verbal intelligence was associated with the presence of some diabetic complications and with a slower walking speed, a measure of physical functioning. Educational level largely explained these associations. This implies that clinicians should be aware of the educational level of people with diabetes and should provide information at a level of complexity tailored to the patient. This article is protected by copyright. All rights reserved.

Original languageEnglish
Pages (from-to)1632–1639
Number of pages8
JournalDiabetic Medicine
Volume33
Issue number12
Early online date1 Mar 2016
DOIs
Publication statusPublished - Dec 2016

Keywords

  • HEALTH LITERACY
  • SOCIOECONOMIC-STATUS
  • CAROTID-ARTERY
  • RISK-FACTORS
  • KNOWLEDGE
  • AGE

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