Association between diabetes and cognitive function at baseline in the Brazilian Longitudinal Study of Adult Health (ELSA- Brasil)

Abstract

Diabetes has been associated with cognitive changes and an increased risk of vascular dementia andAlzheimer's disease, but it is unclear whether there are associations between diabetes and early alterations in cognitive performance. The present study consisted of a cross-section analysis of 14,444 participants aged 35-74 years and from a developing country at baseline in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil); these participants were recruited between 2008 and 2010. We investigated whether there was an association between diabetes and early changes in the cognitive performance of this Brazilian population. To assess cognitive domains, we used the word-list learning, word-list delayed recall and word recognition tests along. Phonemic verbal fluency tests included semantic phonemic test (animals) and a phonemic test (words beginning with the letter f). executive functions associated with attention, concentration and psychomotor speed were evaluated using the Trail Making Test B. The exposure variable in the study was defined as diabetes. Multiple linear regression was used to estimate the association between diabetes and cognitive performance. the results were adjusted for age, sex, education, hypertension, coronary disease, depression, physical activity, smoking, alcohol consumption, and the cholesterol/HDL-C ratio. We found a significant association between diabetes and decreased memory, language and executive function (attention, concentration and psychomotor speed) performance in this population from a country with a distinct epidemiological profile, even after adjusting for the main intervening variables.The world population is ageing, and the incidence of neurodegenerative diseases associated with age is increasing. Diabetes mellitus (diabetes) has been associated with cognitive changes and an increased risk of vascular dementia 1 and Alzheimer's disease 2 . The number of people diagnosed with diabetes worldwide is approximately 422 million individuals 3 . Cognitive dysfunction in individuals with diabetes can result from interactions between inherent metabolic abnormalities, such as hyperglycaemia, hyperinsulinaemia, and micro-and macrovascular complications, in addition to hypertension, dyslipidaemia, depression and obesity 4-7 . The precise mechanisms involved in degenerative diseases in patients with diabetes are unknown and not fully understood; thus, they are considered quite complex and dynamic 8 .Some studies show a worse performance in cognitive tests among patients with diabetes than among individuals without diabetes, with deficits in several domains, especially executive function, memory, psychomotor speed and attention 9,10 . A systematic review that included case-control and population-based studies showed that the risk of overall cognitive dysfunction was increased in people with diabetes in five of seven cohorts. In addition, the association of decreased cognitive performance in one or more domains in was reported in 13 of the 20 cross-sectional studies and in five of t...

Exendin-4 improves long-term potentiation and neuronal dendritic growth in vivo and in vitro obesity condition

“…A recent study has reported that metabolic conditions such as type 2 diabetes and obesity are directly linked to cognitive impairment in the central nervous system (CNS) 4 . In addition, one study has demonstrated that patients with type 2 diabetes and obesity experience accelerated memory loss and impaired verbal fluency compared to normal subjects 5 .…”

“…Metabolic imbalance leads to chronic inflammation, insulin resistance, oxidative stress, vascular damage, and impaired lipid and glucose metabolism in the systemic circulation and CNS 6 . These may contribute to changes in brain function and metabolic stress in the body 4 .…”

Impact of Cognitive Impairment on Adherence to Treatment and Self-Care in Patients with Type 2 Diabetes Mellitus

“…Teixeira et al confirmed an association between diabetes and cognitive performance, mainly in the domains of memory, attention, concentration, psychomotor speed and executive function. 38 Hewitt et al reported that insulin-dependent older persons with cognitive impairment had poorer knowledge about managing hypoglycemia and medications than did patients without impairment. 31 Patients with poor glycemic control lacked understanding of basic self-care (mechanisms of medications, concepts of glucose monitoring, symptom detection, role of exercise, dietary instructions, and behavior-lifestyle adjustment), and had difficulty detecting and solving problems.…”

Exendin-4 Improves Long-Term Potentiation and Neuronal Dendritic Growth in High-Fat Diet Mice and Neurons Under Metabolic Imbalance Conditions

“…Metabolic imbalance leads to chronic inflammation, insulin resistance, oxidative stress, vascular damage, and impaired lipid and glucose metabolism in the systemic circulation and CNS 6 . These may contribute to changes in brain function and metabolic stress in the body 4 .…”

“…Recent study has reported that metabolic conditions such as type 2 diabetes and obesity are directly linked to cognitive impairment in the central nervous system (CNS) and metabolic problems 4 . In addition, one study has demonstrated that patients with type 2 diabetes and obesity experience accelerated memory loss and impaired verbal fluency compared to normal subjects 5 .…”