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Comparative Study
. 2015 Jun;63(6):1075-83.
doi: 10.1111/jgs.13441. Epub 2015 Jun 11.

Relationship Between Type 2 Diabetes Mellitus and Cognitive Change in a Multiethnic Elderly Cohort

Katherine J Bangen  1   2 , Yian Gu  3 , Alden L Gross  4 , Brooke C Schneider  5 , Jeannine C Skinner  6 , Andreana Benitez  7 , Bonnie C Sachs  8 , Regina Shih  9 , Shannon Sisco  10 , Nicole Schupf  3   11   12 , Richard Mayeux  3   11   12   13   14 , Jennifer J Manly  3   12   14 , José A Luchsinger  11   15
Affiliations
Comparative Study

Relationship Between Type 2 Diabetes Mellitus and Cognitive Change in a Multiethnic Elderly Cohort

Katherine J Bangen et al. J Am Geriatr Soc. 2015 Jun.

Abstract

Objectives: To examine the association between diabetes mellitus and cognitive functioning at baseline and cognitive change over time in a large, ethnically diverse sample of older adults.

Design: Prospective cohort study.

Setting: Washington Heights-Inwood Columbia Aging Project, a community-based, prospective study of risk factors for dementia in northern Manhattan, New York City.

Participants: Hispanic, non-Hispanic black, and non-Hispanic white men and women aged 65 and older without dementia at baseline (N = 1,493).

Measurements: Participants underwent baseline and follow-up cognitive and health assessments approximately every 18 months. Generalized estimating equations were used to examine the longitudinal association between diabetes mellitus and cognition.

Results: Diabetes mellitus was associated with poorer baseline cognitive performance in memory, language, processing speed and executive functioning, and visuospatial abilities. After adjusting for age, education, sex, race and ethnicity, and apolipoprotein-ε4, participants with diabetes mellitus performed significantly worse at baseline than those without in language and visuospatial abilities. There were no differences between those with and without diabetes mellitus in terms of rate of cognitive change over a mean follow-up time of 6 years.

Conclusion: The rate of cognitive change in elderly persons with and without diabetes mellitus is similar, although cognitive performance is poorer in persons with diabetes mellitus. These findings suggest that cognitive changes may occur early during the diabetes mellitus process and highlight the need for studies to follow participants beginning at least in midlife, before the typical later-life onset of dementia.

Keywords: aging; cognition; diabetes mellitus; vascular risk factors.

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Conflict of interest statement

Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper.

Figures

Figure 1
Figure 1
Flow chart showing participant selection process
Figure 2
Figure 2
Regression (GEE predicted z scores from adjusted models) of change in performance in memory, language, processing speed/executive functioning, and visuospatial abilities by diabetes mellitus status from unadjusted models. * Older adults with diabetes performed significantly more poorly at baseline relative to those without diabetes (p < .05).
See this image and copyright information in PMC

References

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