Type 2 Diabetes and Cognitive Functions in Middle Age: A Meta-Analysis

Abstract

Objective: Type 2 diabetes mellitus has been linked with cognitive decrement and an increased risk of dementia in older people. Less is known about whether diabetes affects cognition at younger ages. The objective of this meta-analysis was to examine possible differences (effect sizes) in cognitive performance between middle-aged type 2 diabetic patients and healthy controls. Secondary aim was to examine whether age is related to the magnitude of effect sizes. Method: Electronic databases and lists of references of selected articles were used to search for studies examining type 2 diabetes and cognition in patients under age 65 compared to healthy controls. Twelve studies met the inclusion criteria. Standardized mean differences (Hedges's g) were calculated for main cognitive domains and their subdomains. Association between age and effect sizes was evaluated with meta-regression analyses. Publication bias and methodological quality of the studies were assessed. Results: Patients performed worse than controls in several cognitive functions. The largest differences were found in information processing speed (g=-0.68), attention/concentration (g=-0.55), executive functions (g=-0.51), and working memory (g=-0.51). There was no significance difference in visual memory (g=-0.15). Age was significantly related to the effect size in information processing speed, language, and verbal memory and visual memory. However, the direction of association varied across these cognitive domains. Conclusions:The results suggest that cognitive decrement in diabetes is not restricted to older people, but may begin to appear in middle age. More attention should be paid to early recognition and treatment of diabetes-related cognitive decrement in health care systems.

Effects of β-hydroxybutyrate on cognition in patients with type 2 diabetes

“…Type 2 diabetes (T2D) is associated with a more rapid cognitive decline in mid-and late-life (1,2,3) and increased risk of mild cognitive impairment and dementia disorders (4,5). Cognitive impairment in T2D has been observed for memory, executive function, attention, and processing speed (3,6,7,8,9) and is likely to affect abilities of daily living and diabetes self-management (10,11). The underlying mechanisms for T2D-associated cognitive impairment are largely unknown.…”

Occupational Therapy in Integrated Primary Care: Addressing the Needs of Individuals Experiencing Homelessness

“…Individuals who have experienced homelessness have an increased risk of mental health conditions, substance use, and chronic health conditions, as well as an increased incidence of brain injury (Foster et al, 2010;Jones et al, 2009;Stubbs et al, 2019;Substance Abuse and Mental Health Administration, 2011;Topolovec-Vranic et al, 2017;Zlotnick & Zerger, 2008). Each of these conditions can contribute to decreased cognitive performance, and those with multiple chronic conditions are more likely to experience negative impacts on functional cognition (American Occupational Therapy Association [AOTA], 2019; Pelimanni & Jehkonen, 2019;Wei et al, 2019). Despite a higher risk for mental health and chronic health conditions, individuals experiencing homelessness face significant barriers to managing their health and accessing health services, including rehabilitation services such as occupational therapy (Baggett et al, 2010;Miller-Cribbs et al, 2016;Reid et al, 2008).…”

No Effects of Acute Psychosocial Stress on Working Memory in Older People With Type 2 Diabetes

“…Hippocampal atrophy was found in individuals with T2D, which could correlate with impairments in immediate memory (Gold et al, 2007). However, no previous studies have investigated the acute effects of stress on WM in T2D older people in spite of, as noted above, T2D patients show deficits in WM (for reviews see: Palta et al, 2014;Pelimanni and Jehkonen, 2018;Kim, 2019).…”