Differences in the Cognitive Function of Mexican Adults Aged 60 and Older with Self-Reported Diabetes in 2001 and 2018

Abstract

Background: The prevalence of type 2 diabetes in Mexico has nearly doubled for adults aged ≥60. Increases in education and healthcare resources to manage chronic conditions have contributed to population-level increases in the cognitive functioning of older adults. However, research has not focused on older adults with chronic conditions such as diabetes.

Objective: Our objective was to compare the cognitive functioning of Mexican adults aged ≥60 with diabetes in 2001 and 2018.

Methods: Data came from Mexican Health and Aging Study. Our study used a cross-sectional design and included participants aged ≥60 with self-reported diabetes during the 2001 (n = 1,052, mean age = 68.4, female = 59.6%) and 2018 (n = 2,469, mean age = 70.6, female = 62.0%) observation waves. Five cognitive tests were used to create a score of global cognition. Generalized estimating equations were used to compare global cognition in 2001 to 2018.

Results: Older adults in 2018 had more education and were more likely than older adults in 2001 to take oral medication for diabetes, insulin, and to check blood sugar weekly. Older adults in 2018 had higher global cognition than in 2001 when adjusting for age, gender, education, and health insurance coverage (b = 0.38, SE = 0.02). This statistically significant difference remained after adjusting for health conditions, health behaviors, and diabetes management behaviors.

Conclusions: Older adults in Mexico with self-reported diabetes in 2018 had higher cognitive function than in 2001. Future research is needed to investigate causes of the cohort differences in cognitive functioning among Mexican older adults with self-reported diabetes.

Keywords: Alzheimer’s disease; Mexico; cognition; diabetes mellitus; epidemiology.

Fig. 1

Sample selection criteria for Mexican Health and Aging participants aged 60 and older with self-reported diabetes during the 2001 and 2018 observation waves.

Fig. 2

Adjusted risk ratios for the use of oral medications, insulin, diet, and weekly blood glucose checks for adults with self-reported diabetes aged ≥60 years in 2018 compared to adults aged ≥60 years in 2001. RR estimated from generalized estimating equation models with clustering by participant, exchangeable correlation structure, and a log link function. Oral medication, insulin, diet, and check blood glucose were modeled separately. All analyses adjusted for demographic characteristics, health behaviors, and self-reported health conditions.