Type 2 diabetes may be associated with exacerbated aging-related declines in cognitive neuropsychological performance. The authors examined whether such effects are systematic (i.e., broadly distributed across domains or domain-specific) or moderated by age (i.e., varying across age within older adults). The authors assembled recent cross-sectional data from the Victoria Longitudinal Study (VLS) Sample 3 (Wave 1; initial n = 570; initial age = 53-90 years). Using a comprehensive, multidimensional spectrum of cognitive neuropsychological tests, the authors examined performance differences by diabetes status (diabetes group vs. healthy controls) and age (young-old vs. old-old). Our results showed that healthy controls significantly outperformed the diabetes group only on markers of executive functioning and speed. Notably, the diabetes-related effects were robust across the two late-life age groups. Future research examining longitudinal changes is recommended. Keywordstype 2 diabetes; cognitive aging; executive function; speed Type 2 diabetes is a chronic metabolic condition characterized by abnormally high blood glucose levels as a result of insufficient usage of insulin. Formerly known as Non-Insulin Dependent Diabetes Mellitus or adult-onset diabetes, its prevalence significantly increases across adulthood, typically affecting individuals over the age of 40 years (Votey & Peters, 2005). Recent estimates on the prevalence of diabetes (Type I and Type II) have indicated diagnosis rates for adults over age 60 at about 12% in Canada (Health Canada, 2002) and 20% in the United States (National Institute of Health, 2005). Approximately 90% of these cases are Type II. Associated with Type 2 diabetes are increased risk of hypertension, stroke, and cerebrovascular disease (e.g., Awad, Gagnon, & Messier, 2004;Messier, 2005;Reunanen, Kangas, Martikainen, & Klaukka, 2000). These potential comorbidities have been shown to affect neural integrity and cognition, especially when coexistent with diabetes . Recent literature has reported a relationship between diabetes and an earlier or accelerated decline in cognition (e.g., Awad et al., 2004;Hassing, Grant, et al., 2004;Hassing et al., 2003), including a twofold increase in the risk of dementia (Nilsson, 2006).Few studies have examined whether adverse cognitive effects of diabetes are broad or selective across domains, or whether such effects differ across a broad age band of older adults. We explore these issues with a relatively healthy and generally cognitively intact sample of 53-90 year-old adults tested on multiple domains of cognitive neuropsychological performance. Copyright 2008 by the American Psychological AssociationCorrespondence concerning this article should be addressed to Roger A. Dixon, Department of Psychology, P-217 Biological Sciences Building, University of Alberta, Edmonton, Alberta Canada. E-mail: E-mail: rdixon@ualberta.ca. NIH Public Access Author ManuscriptNeuropsychology. Author manuscript; available in PMC 2009 July 18. Published in final ...

Type 2 diabetes is associated with cognitive deficits, although inconsistently across neuropsychological domains. We examined 3-year longitudinal data from the Victoria Longitudinal Study, comparing diabetes (n = 28) and control (n = 272) older adults on a comprehensive neuropsychological battery. Assessing potential change and stability, we found that (a) baseline diabetes group deficits in semantic speed and speed-intensive executive function were preserved, (b) new average deficits for reaction time and nonspeeded executive function appeared, and (c) no differential short-term change was observed. It is clinically and theoretically important to examine sequential change in multiple domains over time. KeywordsAging; Cognition; Type 2 diabetes; Longitudinal; Speed Type 2 diabetes is a chronic, aging-related disease with documented deleterious effects on cognitive performance in older adults. Effects of diabetes on the aging brain are of particular interest given its relationship to increased risk of stroke, cerebrovascular disease, and dementia (e.g., Ott et al., 1996;Reunanen, Kangas, Martikainen, & Klaukka, 2000;Stegmayr & Asplund, 1995;Xu, Qiu, Wahlin, Winblad, & Fratiglioni, 2004). Recent estimates on the prevalence of type 2 diabetes in adults over the age of 60 are as high as 18−20% in North America (National Institute of Health, 2005; Public Health Agency of Canada, 2007)-a rate that may increase dramatically in the near future (Wild, Roglic, Green, Sicree, & King, 2004). Although many studies have reported that type 2 diabetes is related to overall cognitive dysfunction, the patterns of results are mixed regarding affected cognitive domains, potentially moderating comorbidities, and suspected underlying neural mechanisms. In fact, studies have reported contrasting effects for some cognitive domains, including the absence of any diabetes-related deficits (e.g., Robertson-Tchabo, Arenberg, Tobin, & Plotz, 1986;Vanhanen et al., 1999). Address correspondence to Roger A. Dixon, Department of Psychology, P-217 Biological Sciences Building, University of Alberta, Edmonton, Alberta, Canada T6G 2E9 (E-mail: rdixon@ualberta.ca).. Publisher's Disclaimer: Full terms and conditions of use: http://www.informaworld.com/terms-and-conditions-of-access.pdf This article may be used for research, teaching and private study purposes. Any substantial or systematic reproduction, re-distribution, reselling, loan or sub-licensing, systematic supply or distribution in any form to anyone is expressly forbidden. The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material. NIH Public Access NIH-PA Au...

BackgroundHypertension guidelines recommend home blood pressure (HBP) monitoring in adjunct to office blood pressure (OBP) for its greater reproducibility and prognostic utility in the prevention of cardiovascular outcomes, especially stroke. To date, the relationship between HBP and cognitive function remains unexplored.MethodsWe examined HBP as a cognitive predictor in a multi-ethnic group of community-dwelling adults aged 60 and over (N = 133) using neuropsychological measures and analyzed the data using multiple regression analyses. We also employed “everyday cognition” measures that have been found to have higher prognostic utility for real-world functioning than traditional cognitive tasks.ResultsGood to perfect HBP monitoring compliance over seven days was achieved by 88.7% of the participants with superior reliability (ICC≥.96) to office readings. Higher home systolic BP and pulse pressure predicted worse processing speed, executive function, and everyday cognitive function, whereas lower home diastolic BP predicted worse everyday cognition. Office readings were similarly associated with everyday cognitive function but with no other cognitive measures.ConclusionOur findings are the first to validate HBP as a predictor of neuropsychological function in older adults beyond cognitive screening. Differential relationships among blood pressure variables and specific cognitive domains were observed. With proper standardization and training, we demonstrated that HBP can be obtained in a multi-ethnic community-dwelling older adult cohort. Our findings emphasize the importance of employing blood pressure and cognitive measures that are adequately sensitive to detect vascular-related cognitive impairment in a relatively healthy population. Implications regarding proper HBP measurement for hypertension management, cognitive health, and everyday function are discussed.

These results support that blood pressure may be an important predictor of everyday cognitive abilities in older age. Potential implications for real-world functioning are discussed.

Current results extend previous findings by showing that the relationship between increased depressive symptoms and decreased EPS ability in older age may be primarily driven by anhedonia as opposed to other depressive symptoms.