Diabetes and cognitive function in a population-based study of elderly women and men (original) (raw)
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The Association Between Diabetes and Cognitive Function in Later Life
Current Aging Science, 2019
Introduction: Although diabetes through several possible mechanisms such as increased microvascular pathology and inefficiency of glucose utilization during cognitive tasks can be associated with cognitive impairment, there is inconclusive evidence that shows elderly diabetic patients under therapy have higher cognitive function compared to their non-diabetics counterparts. The present study was conducted to elucidate the association between diabetes and cognitive function in later life. Methods: Data for this study, consisting of 2202 older adults aged 60 years and above, were taken from a population-based survey entitled “Identifying Psychosocial and Identifying Economic Risk Factor of Cognitive Impairment among Elderly. Data analysis was conducted using the IBM SPSS Version 23.0. Results: The mean of MMSE was found to be 22.67 (SD = 4.93). The overall prevalence of selfreported diabetes was found to be 23.6% (CI95%: 21.8% - 25.4%). The result of independent t-test showed diabetic...
The association between diabetes and cognitive changes during aging
Scandinavian Journal of Primary Health Care, 2020
Background: Worldwide, we are observing a rising prevalence of dementia and mild cognitive impairments that often co-occur with the heightened incidence of non-communicable diseases in the elderly. It is suggested that type 2 diabetes and defects in glucose metabolism might predispose to poorer cognitive performances and more rapid decline in old age. Methods: to address existing knowledge gaps in this area, we systematically reviewed the literature to identify whether patients with type 2 diabetes (T2DM) and pre-diabetes are at a higher risk of poorer cognitive performance, and whether the risk (if any) might affect specific cognitive abilities. We concentrated the review on elderly individuals (65 years or older) at intake. In total, 3251 original articles were retrieved, of which 17 met our inclusion and quality control criteria, which comprised 12 structured questions used to define the articles. Results: 11 of 17 studies found a statistically significant decline in cognition among individuals who had T2DM or pre-diabetes compared to their non-diabetic counterparts. The association between diabetes and cognitive decline was not always clear, and the extent of the cognitive tests used seemed to have the greatest effect on the results. Conclusion: Focusing on a population age 65 years and over, we found insufficient evidence to support an association between pre-diabetes stages and mild cognitive impairment. However, there is consistent evidence to support diabetes as an independent risk factor for low cognitive ability in the elderly. Finally, we found insufficient evidence to support effect of T2DM on distinct cognitive ability due to the scarcity of comparable findings.
Diabetes as a Risk Factor for Cognitive Decline in Older Patients
Dementia and Geriatric Cognitive Disorders, 2008
To assess the role of type 2 diabetes as a risk factor for cognitive decline among elderly people. Methods: Analyses were carried out on data from the Italian Longitudinal Study on Aging, a study on 5,632 subjects aged 65-84 years, with baseline in 1992 and follow-ups in 1996 and 2000. Results: At baseline, diabetic women had significantly worse scores on all cognitive tests compared to nondiabetic women, but did not show worsening over time, whereas men with diabetes did not show worse scores on cognitive tests at baseline compared to nondiabetic males; however, diabetes in men was associated with a risk of cognitive decline over time, particularly in attention. Higher levels of HbA 1c were associated with poorer performance on memory tests at follow-up in both sexes. Conclusion: The impact of diabetes on cognitive status might differ in older men and women, probably because of a survival effect, with a higher mortality at a younger age among diabetic men. The metabolic and cardiovascular abnormalities associated with diabetes might be responsible for the cognitive decline, at different rates and ages, in men and women. The routine assessment of diabetes complications in the elderly should include cognitive evaluation in both sexes.
COGNITIVE FUNCTION-A COMPARISON BETWEEN ELDERLY NON DIABETIC AND DIABETIC SUBJECTS
Introduction:- Increase in life expectancy and fall in death rate has led to rise in the proportion of the elderly in the community all over the world. The ageing population is facing a double epidemic of dementia including Alzheimer’s disease and diabetes mellitus. The increase in diabetes among elderly is concerning because, in addition to the traditional diabetes complications like acute hyperglycemic and hypoglycemic events and vascular complications, diabetes also affects the central nervous system, a complication referred to as ‘diabetic encephalopathy’, which presents as impaired cognitive functioning and is also associated with an increased risk of dementia. Hence this study was under taken to draw attention to the occurrence of cognitive impairment in type 2 diabetes mellitus, in our community, and thereby pave the way for future initiatives to reduce its incidence. Aim and objectives:- To compare the cognitive functions of elderly non-diabetic subjects with that of elderly type 2 diabetes mellitus subjects using standard neuropsychological tests and to correlate with their blood sugar and lipid levels. Materials and methods:- The study was conducted in 60 participants in the age group of 58-65 years. Of these the case group comprised of 30 individuals with type 2 diabetes mellitus and the control group was formed by age, gender and education matched non-diabetic individuals. Blood samples were collected from all participants. After a brief screening test the participants were asked to take the neuropsychological test battery for evaluating their cognitive status. Comparison of the raw test scores of the cases and controls was done using the student‘t’ test. Results and conclusion:- The diabetes group showed poorer performance in all the cognitive function tests than the non-diabetes group with no correlation between blood glucose and cholesterol levels and the neuropsychological test scores of the patients. Hence, it can be concluded that periodical assessment of cognitive functions in diabetes clinics would be helpful in early identification and management of cases with cognitive impairment, which in turn can reverse the cognitive decline and prevent the development of dementias in these patients.
Type 2 Diabetes Mellitus and Cognitive Function in the Elderly
Iranian Journal of Psychiatry and Behavioral Sciences, 2018
Background: Cognitive impairment is one of the complications experienced by older adults with diabetes. Objectives: This study was conducted to assess the association of cognitive function with the glycemic condition of the elderly population. Methods: This analytic cross-sectional study was conducted on individuals 60 years and over in Babol, Northern Iran, during 2014 and 2015. Sociodemographic characteristics, history of other chronic diseases, medications, physical examination, fasting blood glucose, and serum lipid profile were used for data collection. MMSE was used to assess cognitive function and GDS for depressive symptoms. Results: A total of 1,503 individuals participated in the study. The mean age of the participants was 69.07 ± 7.28 years; of them, 1,038 (69.1%) were normoglycemic (non-diabetic) and 465 had (31.9%) diabetes mellitus. There were significant differences in weight, BMI, systolic blood pressure, serum TG, LDL, and past medical history of MI or angina pectoris between diabetic and non-diabetic patients (P < 0.05). Of the elderly, 1,042 (69.3%) had normal cognition and 461 (30.7%) showed impaired cognition according to MMSE cut values. The mean of MMSE score in non-diabetic and diabetic patients was 25.51 ± 3.40 (25.30-25.72) and 25.02 ± 3.86 (24.63-25.46), respectively (P = 0.018). A significant difference was observed in the severity of cognitive impairment between the two groups (P = 0.048). Conclusions: Older adults with diabetes mellitus have poorer cognitive functions, therefore, health care providers and family physicians should pay more attention to the identification of any cognitive decline in the initial stages of diabetes mellitus.
Diabetes mellitus and cognitive performance in older women
Annals of Epidemiology, 2003
This cross-sectional study sought to identify diabetes accurately in a study population of 3681 women age 75 and older and to determine the association of diabetes with cognitive performance. METHODS: A previously validated test, the Telephone Interview of Cognitive Screening-Modified (TICSm) was given to assess cognitive status. A diabetes case identification database, medical record review and self-report were used to determine diabetes cases. 489 (13.3%) of the women in the study were classified with diabetes and 3192 without diabetes. RESULTS: t-tests and linear regression analyses determined that diabetic women had a mean TICSm score 1.4 points lower (i.e. more impaired) than non-diabetic women. Using linear regression to adjust for age, education, and vascular disease, diabetic women showed a 1.1 lower score on the TICSm. Similar adjustments were made for potential confounding variables such as depression, hormone replacement therapy (HRT), high body weight, smoking, alcohol use and exercise and diabetics again showed a 1.0 lower score. CONCLUSION: This study, which utilizes highly rigorous case identification methodology, provides further evidence that diabetes is associated with significantly worse cognitive performance in the elderly.
European Journal of Pharmacology, 2004
Type 2 diabetes and dementia in the elderly are major public health problems. Cross-sectional studies have suggested that these two conditions may be inter-related, but the nature of this association is uncertain. Causation can only be established through studies with a longitudinal design, taking into account the many potential confounding factors in any study of cognition. A literature search has identified 10 studies (nine population-based and one of case-controlled design) that included a definable diabetic population and assessments of cognitive function at baseline and at follow-up. These 10 studies utilised a combination of domain-specific cognitive assessments and a clinical diagnosis of dementia in the assessment of cognitive function. Diabetes was associated with either an accelerated cognitive decline or an increased incidence of dementia in eight of nine of the population-based studies. One study demonstrated a relationship between diabetes and vascular cognitive impairment, but not with other types of dementia. No association between type 2 diabetes and cognitive decline was demonstrated in the case-controlled study. These studies provide compelling evidence to support the view that people with type 2 diabetes are at increased risk of developing cognitive impairment in comparison with the general population. D
Diabetes Is Associated with Cognitive Decline in Middle-Aged Patients
Metabolic syndrome and related disorders, 2018
Diabetes is a major contributor to dementia in the elderly. Identifying mild cognitive decline in younger individuals with diabetes could aid in preventing the progression of the disease. The aim of our study is to compare whether patients with diabetes experience greater cognitive decline than those without diabetes. We conducted a cross-sectional study using population-based recruitment to identify a cohort of individuals with diabetes and corresponding control group without diabetes of 55-65 years of age. We defined diabetes according to the American Diabetes Association and conducted a battery of standardized neuropsychological tests consisting of nine verbal and nonverbal tasks assessing three cognitive domains. We defined cognitive decline as an abnormal test in one or more of the domains. We used hierarchical regression to predict abnormal cognitive function by diabetes status, adjusting for gender, education, hypertension, and depression. We included 142 patients with diabet...
Predictors of Cognitive Decline in Older Individuals With Diabetes
Diabetes Care, 2008
OBJECTIVE-The purpose of this study was to determine longitudinal predictors of cognitive decline in older individuals with diabetes who did not have dementia. RESEARCH DESIGN AND METHODS-Cognitive assessments were performed in 205 subjects with diabetes (mean age 75.3 years) and repeated a median 1.6 years later. The sample was drawn from an existing cohort study, and data on diabetes, cardiovascular risk factors, and complications were collected 7.6 Ϯ 1.1 years before and at the time of the initial cognitive assessment. Cognitive status was defined using the Clinical Dementia Rating (CDR) scale, and cognitive decline was defined by change in CDR. RESULTS-The sample included 164 subjects with normal cognition (CDR 0) and 41 with cognitive impairment without dementia (CDR 0.5). At follow-up, 33 (16.1%) had experienced cognitive decline (4 new cases of dementia and 29 cognitive impairment without dementia). Only educational attainment predicted cognitive decline from the data collected 7.6 years before cognitive assessment. Univariate predictors of cognitive decline at the time of the first cognitive assessment included age, education, urinary albumin-to-creatinine ratio (ACR), and treatment with either ACE inhibitors (ACEIs) or angiotensin receptor blockers (ARBs). With multiple logistic regression controlling for age and education, cognitive decline was predicted by natural logarithm ACR (odds ratio 1.37 [95% CI 1.05-1.78], P ϭ 0.021), whereas treatment with either ACEIs or ARBs was protective (0.28 [0.12-0.65], P ϭ 0.003). CONCLUSIONS-In this sample of older patients with diabetes, microalbuminuria was a risk factor for cognitive decline, whereas drugs that inhibit the renin-angiotensin system were protective. These observations require confirmation because of their considerable potential clinical implications.
Activitas Nervosa Superior, 2012
Aims of this study was to determine the relationship between diabetes and cognitive impairment is respect of the age of onset and duration of diabetes, other complication of diabetes mellitus and effect of short term glycemic control on cognitive impairment. In the clinical study 50 diabetic patients were examined clinically for evidence of cognitive dysfunction by "Kolkata Cognitive Screening Battery". The scores were compared with the normative data on global cognitive functioning in a population within an urban Indian context. Those having cognitive impairment, follow up was done for six months with adequate anti-diabetic drugs to control their blood sugar strictly (HbA1C <7%). Those who had adequate blood sugar control were again interviewed similarly. The scores were compared with previous values. Results show that cognitive dysfunction was associated with diabetes. Recognition, fluency and immediate memory were most commonly affected. Calculation was least affected. No significant correlation found between cognitive decline with either duration or age of onset of diabetes. The cognitive decline appeared to be reversible as improvement of some mental faculties after strict blood sugar control. In conclusion we have found that cognitive decline was associated with diabetes but not directly related to the duration and age of onset of diabetes. On the other hand, control of diabetes lead to improvement of cognitive function.