Diabetes Is Associated with Increased Rate of Cognitive Decline in Questionably Demented Elderly

Ravona‐Springer, Ramit; Luo, Xiaodong; Schmeidler, James; Wysocki, Michael; Lesser, Gerson T.; Rapp, Michael A.; Dahlman, Karen; Grossman, Hillel; Haroutunian, Vahram; Beeri, Michal Schnaider

doi:10.1159/000265552

Cited by 61 publications

(51 citation statements)

References 86 publications

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“…In both the Rotterdam Study [30] and the Honolulu Asia Aging Study [31], cases of diabetes identified by screening, i.e., those with no prior history of diagnosis and, therefore, presumably a shorter period of exposure, were not associated with elevations in dementia risk, consistent with our findings. Our finding of a non-significant effect of prevalent diabetes on the rate of decline was also partially consistent with a previous study reporting no such association among non-demented or frankly demented individuals [32]. Our results also suggest that the effect of diabetes on dementia risk and cognitive function is largely independent of other cardiovascular disease risk factors.…”

Section: Discussionsupporting

confidence: 92%

Estimating the Cognitive Effects of Prevalent Diabetes, Recent Onset Diabetes, and the Duration of Diabetes among Older Adults

Tchetgen

Osypuk

et al. 2015

Dement Geriatr Cogn Disord

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Background: Little evidence is available on the effects of incident diabetes or diabetes duration on cognitive aging. Methods: We evaluated the effects of prevalent and incident diabetes on deteriorations in cognitive function, based on participants (n = 8,671) aged 65+ in the Health and Retirement Study in 2000. Inverse probability weighting was used to account for selective attrition and time-varying confounding of incident diabetes. Results: Prevalent diabetes predicted higher odds of dementia [odds ratio 1.27; 95% confidence interval (CI) 1.03-1.58] and worse memory (-0.06 in z-score units; 95% CI -0.10 to -0.02), but incident diabetes or diabetes duration up to 8 years of follow-up was not predictive. Conclusion: Prevalent diabetes predicted lower cognition but not recent onset diabetes.

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Section: Discussionsupporting

confidence: 92%

Estimating the Cognitive Effects of Prevalent Diabetes, Recent Onset Diabetes, and the Duration of Diabetes among Older Adults

Tchetgen

Osypuk

et al. 2015

Dement Geriatr Cogn Disord

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“…Comorbid conditions have been associated with dementia [48]; for instance, diabetes is associated with an increased rate of cognitive decline [49]. As discussed in the Results section, in the pcb-Cohort correlations with comorbidities were likewise evident, and there was a significant correlation with GID.…”

Section: Discussionmentioning

confidence: 83%

Screening Younger Individuals in a Primary Care Setting Flags Putative Dementia Cases and Correlates Gastrointestinal Diseases with Poor Cognitive Performance

Rosa¹,

Henriques²,

Carvalho³

et al. 2016

Dement Geriatr Cogn Disord

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Background/Aims: Diagnosing dementia is challenging in many primary care settings, given the limited human resources and the lack of current diagnostic tools. With this in mind, a primary care-based cohort was established in the Aveiro district of Portugal. Methods: A total of 568 participants were evaluated using cognitive tests and APOE genotyping. Results: The findings revealed a dementia prevalence of 12%. A strong correlation between increasing Clinical Dementia Rating (CDR) scores and education was clearly evident. Other highly relevant risk factors were activities of daily living (ADL), instrumental ADL, aging, depression, gender, the APOE ε4 allele, and comorbidities (depression as well as gastrointestinal, osteoarticular, and neurodegenerative diseases). A hitherto unreported, significant correlation between gastrointestinal disease and high CDR score was clearly observable. Conclusions: This study shows the merit of carrying out a dementia screening on younger subjects. Significantly, 71 subjects in the age group of 50-65 years were flagged for follow-up studies; furthermore, these cases with a potentially early onset of dementia were identified in a primary care setting.

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“…[3][4][5][6][7] Despite this, there is not clear evidence that the rate of decline in cognitive function is accelerated among individuals who have T2DM, with some reporting no difference 4,8,9 and others reporting accelerated rates of decline. 10,11 Using data from an annual battery of cognitive tests administered to a large cohort of women who participated in a trial of postmenopausal hormone therapy (HT), we investigated the longitudinal patterns of relative deficits in domainspecific cognitive assessments among women with T2DM. We then examined whether T2DM was associated with an increased rate of cognitive decline across up to 7 years of follow-up.…”

Section: Introductionmentioning

confidence: 99%

Cognitive Function and Fine Motor Speed in Older Women with Diabetes Mellitus: Results from the Women's Health Initiative Study of Cognitive Aging

Espeland

Miller²,

Goveas³

et al. 2011

Journal of Women's Health

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Background: We sought to determine if type 2 diabetes mellitus (T2DM) was associated with accelerated decline in domain-specific measures of cognitive function and fine motor speed. Methods: Women aged 65-80 years who were enrolled in a clinical trial of postmenopausal hormone therapy were grouped as having T2DM (n = 179) or not (n = 1984) and followed for an average of 5 years with annual standardized assessments of domain-specific cognitive function. Mean patterns of cognitive measures over time were contrasted between groups using general linear models and Wald tests, with varying levels of covariate adjustment. The influences of age at onset, use of oral medications, and use of insulin were also examined. Results: T2DM was associated with mean deficits of 0.2-0.4 standard deviations (SD) across follow-up in most cognitive domains. Consistent evidence that rates of decline were accelerated among women with T2DM was evident only for verbal knowledge and verbal memory ( p < 0.05). Decrements in fine motor speed, but no measure of cognitive function, were greater for women with earlier onset T2DM. Use of oral diabetes medications was associated with better relative cognitive function. Conclusions: In these women, T2DM was associated with cognitive deficits in most domains. Relative deficits in verbal knowledge and verbal memory may continue to increase after deficits in other domains have stabilized. Relative deficits in fine motor speed may be greater among women with earlier onsets of T2DM. Use of insulin, which may reflect greater T2DM severity, was associated with relatively greater cognitive deficits.

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Diabetes Is Associated with Increased Rate of Cognitive Decline in Questionably Demented Elderly

Cited by 61 publications

References 86 publications

Estimating the Cognitive Effects of Prevalent Diabetes, Recent Onset Diabetes, and the Duration of Diabetes among Older Adults

Estimating the Cognitive Effects of Prevalent Diabetes, Recent Onset Diabetes, and the Duration of Diabetes among Older Adults

Screening Younger Individuals in a Primary Care Setting Flags Putative Dementia Cases and Correlates Gastrointestinal Diseases with Poor Cognitive Performance

Cognitive Function and Fine Motor Speed in Older Women with Diabetes Mellitus: Results from the Women's Health Initiative Study of Cognitive Aging

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