951-P: Racial and Ethnic Disparities in Diabetes Management, Hospitalization Risk, and Physical Health Status Associated with Cognitive Impairment among Older Adults with Diabetes

Cognitive impairment (CI) is associated with adverse health outcomes, but little is known about whether this varies across different racial and ethnic subgroups. We compared health outcomes associated with CI across racial and ethnic groups among adults aged ≥ 60 years old with diabetes in the US. Adults with diabetes were identified from the 2011-2014 National Health and Nutrition Examination Survey based on self-report and HbA1c labs. Those with the cognitive score (measured by Cognitive Functioning Assessment scale) in the lowest quartile were defined as having CI. We used regression models to compare diabetes management (HbA1c, SBP, and BMI) ; hospitalization; and poor physical health associated with CI across racial and ethnic subgroups, adjusting for age, sex, complications, insurance, income, and education. Of 1465 (357 with CI) adults ≥60 years with diabetes, CI was associated with a higher SBP (adjusted difference (aDifference) : 5.91, 95% CI: 3.25-8.57) in non-Hispanic White individuals and non-Hispanic Black individuals (aDifference: 12.07, 95% CI: 4.94-19.2) . CI was not associated with an increase in Hispanic individuals (aDifference: 3.16, 95% CI: 1.52-4.57) and decrease in non-Hispanic Black individuals (aDifference: -1.79, 95% CI: -0.72,-3.11) . For hospitalization, CI was associated with an increase risk in non-Hispanic Black individuals (adjusted odds ratio (aOR) : 1.78, 95% CI: 1.11-2.37) and a decrease risk in Hispanic individuals (aOR: 0.63, 95% CI: 0.36-0.95) . CI was associated with an increase in the risk among non-Hispanic Black individuals (aOR: 1.83, 95% CI: 1.03-2.14) and Hispanic individuals (aOR: 2.91, 95% CI: 1.45-3.8) . The impact of CI on older adults with diabetes varied across racial and ethnic subgroups, with non-Hispanic Black and Hispanic adults experiencing mostly adverse health outcomes compared to non-Hispanic White individuals.