Seniors with Diabetes, Poor Glucose Control Show Greater Cognitive Decline
Supports hypothesis that older adults with diabetes have reduced cognitive function, poor glycemic control
may be contributor
June 18, 2012 - Among well-functioning older adults without dementia, diabetes mellitus (DM) and poor glucose control
are associated with worse cognitive function and greater cognitive decline, according to a report published Online First
by Archives of Neurology, a JAMA Network publication.
Findings from previous studies have suggested an association between diabetes mellitus and an increased risk of cognitive
impairment and dementia, including Alzheimer disease, but this association continues to be debated, and less is known regarding incident DM in
late life and cognitive function over time, the authors write as background in the study.
Kristine Yaffe, M.D., of the University of California, San Francisco and the San Francisco VA Medical Center, and
colleagues evaluated 3,069 patients (average age, 74.2 years; 42 percent black; 52 percent female) who completed the Modified Mini-Mental
State Examination (3MS) and Digit Symbol Substitution Test (DSST) at baseline and selected intervals over 10 years.
At the beginning of the study, 717 patients (23.4 percent) had prevalent DM and 2,352 (76.6 percent) were without DM, 159 of whom
developed DM during follow-up.
Patients who had prevalent DM at baseline had lower 3MS and DSST test scores than patients without DM, and results from
analysis show similar patterns for 9-year decline with participants with prevalent DM showing significant decline on both the 3MS and DSST
compared with those without DM.
Also, among participants with prevalent DM at baseline, higher levels of hemoglobin A1c (HbA1c) were associated with
lower 3MS and DSST scores.
After adjusting for age, sex, race and education, however, scores remained significantly lower for those with mid (7% to
8%) and high (8% or higher) HbA1c levels on the 3MS but were no longer significant for the DSST.
“This study supports the hypothesis that older adults with DM have reduced cognitive function and that poor glycemic
control may contribute to this association,” the authors conclude.
“Future studies should determine if early diagnosis and treatment of DM lessen the risk of developing cognitive
impairment and if maintaining optimal glucose control helps mitigate the effect of DM on cognition.”
This work was supported by contracts and grants from the National Institute on Aging, and a grant from the National
Institute of Nursing Research. The research was supported in part by the Intramural Research Program of the NIH and NIA, and a grant from the
American Health Assistance Foundation.
Links to Archived Reports on Diabetes
Should YOU be tested for diabetes?
Anyone 45 years old or older should consider getting tested for diabetes. If you are 45 or older and overweight-see the
BMI chart -getting tested is strongly recommended. If you are younger than 45,
overweight, and have one or more of the
risk factors, you should consider getting tested. Ask your doctor for a fasting
blood glucose test or an oral glucose tolerance test. Your doctor will tell you if you have normal blood glucose, prediabetes, or diabetes.
● Among U.S. residents ages 65 years and older, 10.9 million, or 26.9 percent, had diabetes in 2010.
● Diabetes affects 25.8 million people of all ages - 8.3 percent of the U.S. population
> DIAGNOSED - 18.8 million people
●> UNDIAGNOSED - 7.0 million people
● About 215,000 people younger than 20 years had diabetes—type 1 or type 2—in the United States in 2010.
● About 1.9 million people ages 20 years or older were newly diagnosed with diabetes in 2010 in the United States.
● In 2005–2008, based on fasting glucose or hemoglobin A1C (A1C) levels, 35 percent of U.S. adults ages 20 years or
older had prediabetes - 50 percent of adults ages 65 years or older. Applying this percentage to the entire U.S. population in 2010 yields an
estimated 79 million American adults ages 20 years or older with prediabetes.
● Diabetes is the leading cause of kidney failure, nontraumatic lower-limb amputations, and new cases of blindness
among adults in the United States.
● Diabetes is a major cause of heart disease and stroke.
● Diabetes is the seventh leading cause of death in the United States.
Common fears of
weight gain, developing low blood-sugar, decline in quality of life are
largely unfounded, researchers find
Aug. 11, 2009
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