Association of diabetes with amnestic and nonamnestic mild cognitive impairment

Abstract

Background Type 2 diabetes may increase the risk of amnestic mild cognitive impairment (aMCI) through Alzheimer's disease (AD)-related and vascular pathology and may also increase the risk of nonamnestic MCI (naMCI) through vascular disease mechanisms. We examined the association of type 2 diabetes with mild cognitive impairment (MCI) and MCI subtype (aMCI and naMCI) overall and by sex. Methods Participants were Olmsted County, Minnesota residents (70 years and older) enrolled in a prospective, population-based study. At baseline and every 15 months thereafter, participants were evaluated using the Clinical Dementia Rating scale, a neurological evaluation, and neuropsychological testing for a diagnosis of normal cognition, MCI, and dementia by a consensus panel. Type 2 diabetes was ascertained from the medical records of participants at baseline. Results Over a median 4.0 years of follow-up, 348 of 1450 subjects developed MCI. Type 2 diabetes was associated (hazard ratio [95% confidence interval]) with MCI (1.39 [1.08–1.79]), aMCI (1.58 [1.17–2.15]; multiple domain: 1.58 [1.01–2.47]; single domain: 1.49 [1.09–2.05]), and the hazard ratio for naMCI was elevated (1.37 [0.84–2.24]). Diabetes was strongly associated with multiple-domain aMCI in men (2.42 [1.31–4.48]) and an elevated risk of multiple domain naMCI in men (2.11 [0.70–6.33]), and with single domain naMCI in women (2.32 [1.04–5.20]). Conclusions Diabetes was associated with an increased risk of MCI in elderly persons. The association of diabetes with MCI may vary with subtype, number of domains, and sex. Prevention and control of diabetes may reduce the risk of MCI and Alzheimer's disease.

An Update on Type 2 Diabetes Mellitus as a Risk Factor for Dementia

“…T2DM has been found to be associated with MCI or MCI subtypes in middle-aged (50-65 years old) subjects but not in elderly individuals (66-80 years old) [72]. However, T2DM was shown to be associated with an increased risk of MCI in an elderly group of subjects (70 years and older) in another study [75]. High BMI, high 2-hour postprandial glucose, and poor glycemic control were significant independent predictors of cognition impairments in patients with both T2DM and MCI [76].…”

Metabolic relationship between diabetes and Alzheimer's Disease affected by Cyclo(His-Pro) plus zinc treatment

“…T2D has also been associated with an increased risk of vascular dementia [25], and pre-diabetic insulin resistance is a risk factor for AD pathology and reduced memory function [26]. Some studies indicate that improving T2D can delay or prevent AD pathology [27]; and therefore, prevention and control of diabetes may reduce the risk of MCI and AD later in life [28]. A significant association between diabetes and AD has also been reported by linking insulin and glucose metabolism load to β-amyloid levels in AD [29].…”

Association of Plasma DPP4 Activity With Mild Cognitive Impairment in Elderly Patients With Type 2 Diabetes: Results From the GDMD Study in China

“…people with MCI will develop dementia (2), prospective population-based studies link type 2 diabetes to an increased risk of MCI (3,4). The presence of MCI might reduce the threshold at which a dementia process becomes symptomatic (5).…”