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BackgroundObservational studies suggested an association between diabetes and the risk of various geriatric conditions (i.e., cognitive impairment, dementia, depression, mobility impairment, disability, falls, and urinary incontinence). However, the magnitude and impact of diabetes on older adults have not been reviewed.Methodology/Principal FindingsMEDLINE and PSYCINFO databases were searched through November 2007 for published studies, supplemented by manual searches of bibliographies of key articles. Population-based, prospective cohort studies that reported risk of geriatric outcomes in relation to diabetes status at baseline were selected. Two authors independently extracted the data, including study population and follow-up duration, ascertainment of diabetes status at baseline, outcomes of interest and their ascertainment, adjusted covariates, measures of association, and brief results. Fifteen studies examined the association of DM with cognitive dysfunction. DM was associated with a faster decline in cognitive function among older adults. The pooled adjusted risk ratio (RR) for all dementia when persons with DM were compared to those without was 1.47 (95% CI, 1.25 to 1.73). Summary RRs for Alzheimer's disease and vascular dementia comparing persons with DM to those without were 1.39 (CI, 1.16 to 1.66) and 2.38 (CI, 1.79 to 3.18), respectively. Four of 5 studies found significant association of DM with faster mobility decline and incident disability. Two studies examined the association of diabetes with falls in older women. Both found statistically significant associations. Insulin users had higher RR for recurrent falls. One study for urinary incontinence in older women found statistically significant associations. Two studies for depression did not suggest that DM was an independent predictor of incident depression.Conclusions/SignificanceCurrent evidence supports that DM is associated with increased risk for selected geriatric conditions. Clinicians should increase their awareness and provide appropriate care. Future research is required to elucidate the underlying pathological pathway.

Cerebral white matter lesions (WMLs), also called "leukoaraiosis," are common neuroradiological findings in elderly people. WMLs are often located at periventricular and subcortical areas and manifest as hyperintensities in magnetic resonance imaging. Recent studies suggest that cardiovascular risk factors are associated with the development of WMLs. These lesions are associated with different geriatric syndromes such as falls, executive cognitive impairment, depressive symptoms, and urinary incontinence. Damage to associative pathways in frontal and subcortical regions due to hypoperfusion may disrupt frontal executive, motor control, and other systems, resulting in these manifestations. WMLs are associated with substantial disability and should not be considered a benign and silent condition as once believed. Interventions addressing cardiovascular risk factors should be undertaken in early or mid-life in order to prevent late-life functional impairment associated with WMLs. After these lesions develop and impair executive cognitive functions, the patient's ability to comply with a complex risk reduction program may be significantly compromised.

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OBJECTIVES-To assess how elevated body mass index (BMI) affects cognitive function in elderly people. DESIGN-Cross-sectional study.SETTING-Data for this cross-sectional study were taken from a multicenter randomized controlled trial, the Advanced Cognitive Training for Independent and Vital Elderly trial.PARTICIPANTS-The analytic sample included 2,684 normal-weight, overweight, or obese subjects aged 65 to 94.MEASUREMENTS-Evaluation of cognitive abilities was performed in several domains: global cognition, memory, reasoning, and speed of processing. Cross-sectional association between body weight status and cognitive functions was analyzed using multiple linear regression.RESULTS-Overweight subjects had better performance on a reasoning task (β = 0.23, standard error (SE) = 0.11, P = .04) and the Useful Field of View (UFOV) measure (β = −39.46, SE = 12.95, P = .002), a test of visuospatial speed of processing, after controlling for age, sex, race, years of education, intervention group, study site, and cardiovascular risk factors. Subjects with class I (BMI 30.0-34.9 kg/m 2 ) and class II (BMI>35.0 kg/m 2 ) obesity had better UFOV measure scores (β = −38.98, SE = 14.77, P = .008; β = −35.75, SE = 17.65, and P = .04, respectively) in the multivariate model than normal-weight subjects. The relationships between BMI and individual cognitive domains were nonlinear.Address correspondence to Richard N. Jones, ScD, Hebrew Rehabilitation Center for Aged, 1200 Center Street, Boston MA 02131. jones@mail.hrca.harvard.edu. Author Contributions: study concept and design (Kuo, Jones, Milberg, and Lipsitz), acquisition of subjects (Tennstedt, Talbot, and Morris), analysis and interpretation of data (Kuo and Jones), preparation of manuscript (Kuo and Jones), critical revision (Jones, Milberg, Tennstedt, Talbot, Morris, and Lipsitz). Overweight and obesity are growing in prevalence among older adults. 1 The prevalence of overweight and obesity is more than 50% in U.S. adults, with the highest prevalence observed in adults aged 50 and older. 1 In association with various cardiovascular risk factors such as hypertension, diabetes mellitus, and heart disease, overweight and obesity are related to a host of adverse health outcomes in older adults and place a severe burden on the U.S. healthcare system. 2 NIH Public AccessThe relationship between body weight and selected geriatric syndromes has recently attracted significant research interest. Investigators have shown a positive association between body mass index (BMI) and depressive symptoms in elderly people. 3 Studies have demonstrated that, in the elderly population, overweight and obesity were related to self-reported functional limitations, 4 performance-based functional disability, 5 urinary incontinence, 6 and chronic osteoarthritic pain, but controversies still exist regarding the relationship between BMI and cognitive ability in older people. A positive relationship between BMI and cognition has been demonstrated, 7 although some other reports have showed an invers...

Elevation of BP is associated with a selective impairment in executive function in otherwise healthy community-dwelling elders.

Independent of chronic diseases, elevated CRP is associated with multiple domains of disability through mediation of muscle power, habitual gait speed, or both. Future research is needed to understand CRP as a risk factor for disability in older populations.

This pilot study suggests that the PST can distinguish individuals with psoriasis from individuals without psoriasis in an English-speaking population being seen at an outpatient dermatology clinic. Furthermore, the PST may be used to identify psoriasis phenotypes. Although the PST may be limited by spectrum bias in this pilot study, we believe it remains a reliable tool to collect information on psoriasis in remote populations.