Ethnicity/Culture Modulates The Relationships Of The Haptoglobin (Hp) 1-1 Phenotype With Cognitive Function In Older Individuals With Type 2 Diabetes

Objective: The haptoglobin (Hp) genotype has been associated with cognitive function in type 2 diabetes. Because ethnicity/culture has been associated with both cognitive function and Hp genotype frequencies, we examined whether it modulates the association of Hp with cognitive function.Methods: This cross-sectional study evaluated 787 cognitively normal older individuals (> 65 years of age) with type 2 diabetes participating in the Israel Diabetes and Cognitive Decline study. Interactions in two-way analyses of covariance compared Group (Non-Ashkenazi versus Ashkenazi Jews) on the associations of Hp phenotype (Hp 1-1 versus non-Hp 1-1) with five cognitive outcome measures. The primary control variables were age, gender, and education.Results: Compared with Ashkenazi Jews, non-Ashkenazi Jews with the Hp 1-1 phenotype had significantly poorer cognitive function than non-Hp 1-1 in the domains of Attention/Working Memory (p= 0.035) and Executive Function (p= 0.023), but not in Language/Semantic Categorization (p= 0.432), Episodic Memory (p= 0.268), or Overall Cognition (p= 0.082). After controlling for additional covariates (type 2 diabetes-related characteristics, cardiovascular risk factors, Mini-mental State Examination, and extent of depressive symptoms), Attention/Working Memory (p= 0.038) and Executive Function (p= 0.013) remained significant.Conclusions: Older individuals from specific ethnic/cultural backgrounds with the Hp 1-1 phenotype may benefit more from treatment targeted at decreasing or halting the detrimental effects of Hp 1-1 on the brain. Future studies should examine differential associations of Hp 1-1 and cognitive impairment, especially for groups with high prevalence of both, such as African-Americans and Hispanics. Copyright (C) 2015 John Wiley & Sons, Ltd.