A longitudinal study of cognitive performance in noninsulin dependent (type II) diabetic men

Robertson‐Tchabo, Elizabeth A.; Arenberg, David; Tobin, Jordan D.; Plotz, Judith B.

doi:10.1016/0531-5565(86)90051-3

Cited by 58 publications

(52 citation statements)

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“…Our finding of essentially normal memory function is consistent with several other reports of intact learning and memory skills in middle-aged adults with type 2 diabetes (19)(20)(21). To date, only 2 groups have reported memory dysfunction in middle-aged subjects (4,18).…”

Section: Univariate Test Resultssupporting

confidence: 82%

“…On the other hand, the relatively few studies of cognitive function in adults Ͻ65 years of age have, with few exceptions (4,18), failed to find evidence of diabetes-associated cognitive dysfunction (19)(20)(21). Possible reasons for these negative findings include the use of an extremely limited neuropsychological assessment battery (21), very different patient populations (e.g., Native Americans with a relatively more brief duration of diabetes [19]), and small homogeneous samples of very healthy subjects (20).…”

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confidence: 99%

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Circumscribed cognitive dysfunction in middle-aged adults with type 2 diabetes.

2000

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OBJECTIVE -To examine the extent to which type 2 diabetes is associated with poorer performance on measures of learning, memory, psychomotor speed, and problem-solving in middle-aged adults. RESEARCH DESIGN AND METHODS-This cross-sectional study evaluated 50 adults (age range 34-65 years, mean 50.8) with type 2 diabetes and 50 demographically similar community control subjects without diabetes. Each subject received a thorough physical examination and a detailed neuropsychological assessment. Factor analysis was used to assign specific tests to 1 of 4 cognitive domains (learning, memory for stories, problem-solving, and psychomotor speed). Hierarchical regression analysis was used to identify demographic and biomedical variables associated with cognitive dysfunction.RESULTS -Learning, memory, and problem-solving skills were unaffected by type 2 diabetes. In contrast, psychomotor slowing was predicted by a diagnosis of diabetes (r 2 change = 0.075, P Ͻ 0.002) with additional variance in psychomotor efficiency explained independently by HbA 1 (r 2 = 0.064, P Ͻ 0.003) and vibratory threshold (r 2 = 0.112, P Ͻ 0.0001). The magnitude of psychomotor slowing on specific tests ranged from 12% (Digit Vigilance) to 23% (Grooved Pegboard).CONCLUSIONS -Middle-aged adults with type 2 diabetes manifest psychomotor slowing that is associated with poorer metabolic control, whereas learning, memory, and problemsolving skills appear to be largely intact. The development of psychomotor slowing may be a manifestation of a "central neuropathy" induced by chronic hyperglycemia.

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Section: Univariate Test Resultssupporting

confidence: 82%

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confidence: 99%

Circumscribed cognitive dysfunction in middle-aged adults with type 2 diabetes.

2000

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“…Meneilly et al [26] showed that improvement of glycaemic control in patients with NIDDM increased selected aspects of cognition. In contrast, a longitudinal study found no significant relationship between NIDDM and cognitive impairment [27]. However, the subjects with NIDDM were young and had a high level of formal education.…”

Section: Discussionmentioning

confidence: 77%

Glucose intolerance, hyperinsulinaemia and cognitive function in a general population of elderly men

Kalmijn¹,

Feskens²,

Launer³

et al. 1995

Diabetologia

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SummaryCognitive impairment is highly prevalent among the elderly. Subjects with disturbed glucose metabolism may be at risk of impaired cognitive function, as these disturbances can influence cognition through atherosclerosis, thrombosis and hypertension. We therefore studied the cross-sectional association of cognitive function with hyperinsulinaemia, impaired glucose tolerance and diabetes mellitus in a population-based cohort of 462 men aged 69 to 89 years. Cognitive function was measured by the 30-point Mini-Mental State Examination. Results were expressed as the rate ratio (95 % confidence interval) of the number of erroneous answers given on the Mini-Mental State Examination by the index compared to the reference group. Compared to subjects with normal glucose tolerance, known diabetic patients had a rate ratio of 1.23 (1.04-1.46), newly-diagnosed diabetic patients of 1.16 (0.91-1.48) and subjects with impaired glucose tolerance of 1.18 (0.98-1.41), after adjustment for confounding due to age, occupation and cigarette smoking (ptrend = 0.01). Non-diabetic subjects in the highest compared to the lowest quartile of the area under the insulin curve had a rate ratio of 1.24 (1.03-1.50), after adjustment for confounding (p-trend = 0.02). The results did not change appreciably when potentially mediating factors, including cardiovascular diseases and risk factors associated with the insulin resistance syndrome, were taken into account. These results suggest that diabetes, as well as impaired glucose tolerance and hyperinsulinaemia in non-diabetic subjects are associated with cognitive impairment. [Diabetologia (1995[Diabetologia ( ) 38: 1096[Diabetologia ( -1102 Key words Diabetes mellitus, glucose intolerance, insulin, cognition, aged, epidemiology.Cognitive impairment is an important component of dementia, and a major determinant of the quality of life. It is important to identify risk factors for cognitive impairment that are potentially modifiable. There is now substantial evidence that in addition to diabetes mellitus, impaired glucose tolerance and hyperinsulinaemia are also associated with atheroscle-

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“…The impairments found in the present study involved tests in which time or speed is essential. It has been hypothesised that the cognitive performance of diabetic persons is particularly affected when the cognitive task at hand requires speed of response and when the individual has to respond within a fixed time limit [20].…”

Section: Discussionmentioning

confidence: 99%

The impact of diabetes mellitus on cognitive decline in the oldest of the old: a prospective population-based study

et al. 2006

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Aims/hypothesis Diabetes mellitus is a risk factor for the development of cognitive impairment and dementia in the general population up to 75 years of age. As part of the Leiden 85-plus Study we studied the effects of diabetes on cognition in the oldest old. Subjects and methods The Leiden 85-plus Study is a prospective population-based study of 599 persons from age 85 onward. Cognitive function was assessed each year from ages 85 to 90 by means of four neuropsychological tests. The presence of diabetes and vascular disease was recorded at baseline, HbA 1c was assessed by means of a blood sample at ages 85 and 90. The cross-sectional and prospective associations between diabetes and cognitive function were analysed with linear mixed models, adjusted for sex and level of education. Results At age 85, diabetes was associated with a lower level of cognitive functioning on the Letter Digit Coding test and the Stroop Test. Diabetes was not associated with accelerated cognitive decline during follow-up. Within the group of diabetic patients, macrovascular disease was the most important determinant of cognitive dysfunction. Conclusions/interpretation The association between diabetes and accelerated cognitive decline, which has been documented previously in patients up to 75 years of age, may be less evident after age 85. This suggests that the damage occurs in previous years and that therapies aimed at preventing cognitive decline and dementia should focus on the younger old.

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A longitudinal study of cognitive performance in noninsulin dependent (type II) diabetic men

Cited by 58 publications

References 10 publications

Circumscribed cognitive dysfunction in middle-aged adults with type 2 diabetes.

Circumscribed cognitive dysfunction in middle-aged adults with type 2 diabetes.

Glucose intolerance, hyperinsulinaemia and cognitive function in a general population of elderly men

The impact of diabetes mellitus on cognitive decline in the oldest of the old: a prospective population-based study

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