Diabetes Mellitus and Cognitive Decline

Information sourced from NEJM Journal Watch:

Diabetes Mellitus and Cognitive Decline

Diabetes mellitus may be a risk factor for cognitive decline in older adults.

To analyze the incidence of cognitive decline in those with and without preexisting or incident diabetes mellitus, researchers tracked 7740 participants aged ≥65 years from the Chicago Health and Aging Project. Diabetes mellitus (DM) was determined based on the use of hypoglycemic medications, Medicare claims with the diagnosis, or both. Participants completed tests of executive function, episodic memory, and the Mini Mental State Examination every 3 years for up to 12 years. The researchers compared a composite cognitive score between those with and those without incident or preexisting DM after adjustment for age, sex, education, body-mass index, hypertension, stroke, and antihypertensive and statin medication use. Differences between participants of black and European descent were also determined.

Those with incident DM had similar baseline cognitive scores compared with those without DM. On the other hand, among black participants, those with preexisting DM had significantly lower baseline cognitive scores than those with no DM. Both the black and European groups with incident DM had faster rates of cognitive decline than those without DM. The rate of decline was similar between black and European groups. Among black participants, those with preexisting DM had a significantly faster rate of cognitive decline than those without DM. By contrast, among Europeans, those with and without preexisting DM had similar rates of cognitive decline.

COMMENT

People with diabetes mellitus may be at increased risk for cognitive decline. Correlating these findings with activities of daily living and with degree of DM control is needed, but this study provides further evidence that treating DM may decrease the burden of cognitive decline in older adults.

Jennifer Rose V. Molano, MD reviewing Rajan KB et al. Neurology 2016 Sep 21.

CITATION(S):

Rajan KB et al. Cognitive decline following incident and preexisting diabetes mellitus in a population sample. Neurology 2016 Sep 21; [e-pub].
[PubMed® abstract]

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