Type 2 Diabetes Mellitus Is Associated with the Risk of Cognitive Impairment: a Meta-Analysis

Zhang, Xiaojun; Jiang, Xiaoyu; Han, Sufang; Liu, Qianqi; Zhou, Jing

doi:10.1007/s12031-019-01290-3

Cited by 24 publications

(15 citation statements)

References 49 publications

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“…Our results also showed that, compared to participants without diabetes, those with diabetes had a borderline increased risk of developing cognitive impairment as measured by the GCF score, even when the period of follow-up was only 2 years. Meta-analyses including prospective studies have shown an incidence of cognitive impairment in participants with type 2 diabetes (6,33). However, the assessment of short-time periods were not commonly reported in regard to the association between type 2 diabetes and cognitive function, and it may be the reason for the discrepancies observed between the aforementioned meta-analyses and our study.…”

Section: Discussioncontrasting

confidence: 71%

Glycemic Dysregulations Are Associated With Worsening Cognitive Function in Older Participants at High Risk of Cardiovascular Disease: Two-Year Follow-up in the PREDIMED-Plus Study

et al. 2021

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IntroductionType 2 diabetes has been linked to greater cognitive decline, but other glycemic parameters such as prediabetes, diabetes control and treatment, and HOMA-IR and HbA1c diabetes-related biomarkers have shown inconsistent results. Furthermore, there is limited research assessing these relationships in short-term studies. Thus, we aimed to examine 2-year associations between baseline diabetes/glycemic status and changes in cognitive function in older participants at high risk of cardiovascular disease.MethodsWe conducted a 2-year prospective cohort study (n=6,874) within the framework of the PREDIMED-Plus study. The participants (with overweight/obesity and metabolic syndrome; mean age 64.9 years; 48.5% women) completed a battery of 8 cognitive tests, and a global cognitive function Z-score (GCF) was estimated. At baseline, participants were categorized by diabetes status (no-diabetes, prediabetes, and <5 or ≥5-year diabetes duration), and also by diabetes control. Furthermore, insulin resistance (HOMA-IR) and glycated hemoglobin (HbA1c) levels were measured, and antidiabetic medications were recorded. Linear and logistic regression models, adjusted by potential confounders, were fitted to assess associations between glycemic status and changes in cognitive function.ResultsPrediabetes status was unrelated to cognitive decline. However, compared to participants without diabetes, those with ≥5-year diabetes duration had greater reductions in GCF (β=-0.11 (95%CI -0.16;-0.06)], as well as in processing speed and executive function measurements. Inverse associations were observed between baseline HOMA-IR and changes in GCF [β=-0.0094 (95%CI -0.0164;-0.0023)], but also between HbA1c levels and changes in GCF [β=-0.0085 (95%CI -0.0115, -0.0055)], the Mini-Mental State Examination, and other executive function tests. Poor diabetes control was inversely associated with phonologic fluency. The use of insulin treatment was inversely related to cognitive function as measured by the GCF [β=-0.31 (95%CI -0.44, -0.18)], and other cognitive tests.ConclusionsInsulin resistance, diabetes status, longer diabetes duration, poor glycemic control, and insulin treatment were associated with worsening cognitive function changes in the short term in a population at high cardiovascular risk.Clinical Trial Registrationhttp://www.isrctn.com/ISRCTN89898870, identifier ISRCTN: 89898870.

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Section: Discussioncontrasting

confidence: 71%

Glycemic Dysregulations Are Associated With Worsening Cognitive Function in Older Participants at High Risk of Cardiovascular Disease: Two-Year Follow-up in the PREDIMED-Plus Study

et al. 2021

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“…However, longer follow-up of our population may be needed to observe a greater Our results also show that, compared to participants without diabetes, those with diabetes had a borderline increased risk of developing a cognitive impairment as measured by the GCF score, even with only 2 years of follow-up. Meta-analyses including prospective studies showed cognitive impairment in participants presenting type 2 diabetes [6,33]. However, it was not usual to report short-time periods in the association between type 2 diabetes and cognitive function, and it may be the reason for the discrepancies showed between the aforementioned meta-analyses and our study.…”

Section: Discussioncontrasting

confidence: 60%

Longitudinal Associations Between Glycemic Status and Cognitive Function in Older Participants at High Risk of Cardiovascular Disease: Two-Year Follow-Up in the PREDIMED-Plus Study

Martínez

Babió

Júlvez

et al. 2021

Preprint

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BACKGROUND: Type 2 diabetes was related with larger cognitive decline. However, other glycemic dysregulations showed inconsistent results. Our aim was to examine longitudinal associations between diabetes/glycemic status and cognitive function in older adults with metabolic syndrome. METHODS: We conducted a 2-year prospective cohort study (n=6,874) within the framework of the PREDIMED-Plus study. The participants (with overweight/obesity and metabolic syndrome; mean age 64.9 years; 48.5% women) completed a battery of 8 cognitive tests, and a global cognitive function Z-score (GCF) was estimated. Participants were categorized by diabetes status (no-diabetes, prediabetes, and <5 or ≥5-year diabetes duration), and control. At baseline, insulin resistance (HOMA-IR) and glycated hemoglobin (HbA1c) levels were measured and antidiabetic medications were recorded. Linear and logistic regression models, adjusted by potential confounders, were fitted to assess associations between glycemic status and changes in cognitive function. RESULTS: Prediabetes status was unrelated to cognitive decline. However, compared to participants without diabetes, those with ≥5-year diabetes duration had greater reductions in the GCF (β=-0.11 [95%CI -0.16;-0.06]), processing speed and executive function measurements. Inverse associations were observed between baseline HOMA-IR and changes in the GCF (β=-0.0094 [95%CI -0.0164;-0.0023]), but also between HbA1c levels and changes in the GCF (β=-0.0610 [95%CI -0.0889;-0.0331]), the Mini-Mental test, and other executive function tests. Poor diabetes control was inversely associated with phonologic fluency. Sulfonylureas, but especially insulin use, were related to cognitive decline.CONCLUSIONS: Insulin resistance, diabetes status, longer diabetes duration, poor glycemic control, and insulin treatment were associated with worsening cognitive function at short-term in a population at high cardiovascular risk.TRIAL REGISTRATION: ISRCTN, ISRCTN89898870. Registered 28 May 2014 - Retrospectively registered, http://www.isrctn.com/ISRCTN89898870

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“…Increasing evidence indicates a potential effect of T2D on the risk of cognitive dysfunction; however, the correlation between T2D and a cognitive impairment risk is still unclear [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Mild Cognitive Impairment Subtypes and Type 2 Diabetes in Elderly Subjects

Valenza

Paciaroni

Paolini

et al. 2020

JCM

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Background: Type 2 diabetes (T2D) is correlated to amnestic mild cognitive impairment (aMCI) and to non-amnestic mild cognitive impairment (naMCI). This study evaluated whether the T2D variable characterizes a peculiar cognitive profile in elderly patients. Moreover, it explores the association between glycated hemoglobin levels (HbA1c), T2D duration, insulin and oral hypoglycemic agent treatment, and cognition in elderly diabetic patients. Methods: Detailed neuropsychological battery was used to diagnose MCI subtypes. A total of 39 MCI subjects with T2D (T2D-MCI) and 37 MCI subjects without T2D (ND-MCI), matched for age, educational level, and Mini-Mental State Examination score, were included. Results: ND-MCI performed worse in memory and language domains than T2D-MCI. The amnestic subtype is more frequent among ND-MCI and non-amnestic subtype in T2D-MCI. In T2D-MCI, high HbA1c levels correlate with episodic memory (immediate recall) and T2D duration. Some indexes of episodic memory (immediate recall), attention, and visual-spatial ability correlate with insulin treatment. Conclusions: An association between T2D and non-amnestic MCI is suggested. In the T2D-MCI group, significant associations between insulin treatment and memory (immediate recall), complex figure copy, and attention were found.

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Type 2 Diabetes Mellitus Is Associated with the Risk of Cognitive Impairment: a Meta-Analysis

Cited by 24 publications

References 49 publications

Glycemic Dysregulations Are Associated With Worsening Cognitive Function in Older Participants at High Risk of Cardiovascular Disease: Two-Year Follow-up in the PREDIMED-Plus Study

Glycemic Dysregulations Are Associated With Worsening Cognitive Function in Older Participants at High Risk of Cardiovascular Disease: Two-Year Follow-up in the PREDIMED-Plus Study

Longitudinal Associations Between Glycemic Status and Cognitive Function in Older Participants at High Risk of Cardiovascular Disease: Two-Year Follow-Up in the PREDIMED-Plus Study

Mild Cognitive Impairment Subtypes and Type 2 Diabetes in Elderly Subjects

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