Effects of Type 2 Diabetes on 12-Year Cognitive Change

Spauwen, Peggy; Köhler, Sebastian; Verhey, Frans R.J.; Stehouwer, Coen D. A.; Boxtel, M.P.J. van

doi:10.2337/dc12-0746

Cited by 135 publications

(121 citation statements)

References 35 publications

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“…Our findings are consistent with studies that have shown that the DSST detects small cognitive changes in people with high levels of cognition (32) and in people with DM (1,33). The Stroop test, which measures executive function, did not show change in association with albuminuria status.…”

Section: Discussionsupporting

confidence: 92%

Albuminuria and Cognitive Decline in People with Diabetes and Normal Renal Function

Barzilay¹,

Lovato²,

Murray³

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Diabetes mellitus is associated with increased risk of cognitive impairment. This study examines whether microvascular disease, as measured by albuminuria and decline in estimated GFR (eGFR), is associated with cognitive decline during 3.3 years of follow-up in individuals with diabetes with a normal baseline eGFR (approximately 90 ml/min per 1.73 m 2 ). Mixed-effects models were used to assess the association of albuminuria and eGFR on the percentage decline in each test.Results Participants with albuminuria at baseline and follow-up (persistent albuminuria) (25.8% [95% confidence interval (CI), 27.3 to 24.2]) and participants with albuminuria at follow-up but none at baseline (progressive albuminuria) (24.1% [95% CI, 25.6 to 22.7]) had greater percentage declines on information processing speed than participants without albuminuria at baseline and at follow-up (no albuminuria) (22.6% [95% CI, 23.4 to 21.9]) (P=0.001 and P=0.10, respectively). There were borderline percentage changes in the test of verbal memory (4.8% [95% CI, 2.4 to 7.1] and 4.7% [95% CI, 2.5 to 7.0] versus 7.1% [95% CI, 6.0 to 8.3]; P=0.11 and P=0.08, respectively). On logistic regression analysis, persistent albuminuria (odds ratio, 1.37 [95% CI, 1.09 to 1.72]) and progressive albuminuria (odds ratio, 1.25 [95% CI, 1.02 to 1.56]) were associated with a $5% decline in information processing speed scores but not with verbal memory or executive function performance. A 1 ml/min per 1.73 m 2 per year eGFR decline had a borderline association with decline in tests of cognitive function.Conclusions Persistent albuminuria and progressive albuminuria are associated with a decline in cognitive function in relatively young individuals with diabetes with unimpaired eGFR. These findings do not rule out the possibility of other processes causing cognitive decline.

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Section: Discussionsupporting

confidence: 92%

Albuminuria and Cognitive Decline in People with Diabetes and Normal Renal Function

Barzilay¹,

Lovato²,

Murray³

et al. 2013

Clinical Journal of the American Society of Nephrology

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“…Similar results have been reported previously, especially regarding the impact on physical function (11,15). Geriatric dysfunctions, and especially cognitive disorders, have been suspected to be associated with poor diabetes control (16)(17)(18). Conversely, poor metabolic control and especially hypoglycemia, has been suspected to favor cognitive decline (19,20).…”

Section: Discussionsupporting

confidence: 85%

Cardiovascular Events and Geriatric Scale Scores in Elderly (70 Years Old and Above) Type 2 Diabetic Patients at Inclusion in the GERODIAB Cohort

Bauduceau

Doucet

Floch³

et al. 2013

Diabetes Care

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OBJECTIVETo analyze the relationships between cardiovascular complications and geriatric scale scores in French elderly ( ‡70 years of age) type 2 diabetic patients at inclusion in the GERODIAB cohort. RESEARCH DESIGN AND METHODSGERODIAB is the first French multicenter, prospective, observational survey designed to analyze the influence of glycemic control on morbidity/mortality in type 2 diabetic patients aged ‡70 years during a 5-year follow-up period. This study analyzed the relationships between classical macroangiopathic complications and geriatric scale scores in 987 patients at baseline, using bivariate and multivariate analyses. RESULTSCardiac ischemia (31.2%) was significantly associated with impaired activities of daily living (ADL) scores (P < 0.001). Stepwise logistic regression included hypercholesterolemia, ADL, sex, and hypertension successively (70.3% concordance; P < 0.001). Heart failure (10.1%) was associated with impaired Mini Mental State Examination (MMSE), instrumental ADL (IADL) (P < 0.05), and ADL scores (P < 0.001). With the logistic model, waist circumference, age, and HDL cholesterol were significant factors (70.7% concordance; P < 0.001). Arterial disease of the lower limbs (25.6%) was associated with impaired IADL and ADL scores (P < 0.001). Significant factors using the logistic model were duration of diabetes, IADL score, hypertension, and sex (62.8% concordance; P < 0.001). Cerebral ischemia (15.8%) was associated with impaired MMSE, Mini Nutritional Assessment, ADL, and IADL scores (P < 0.01). IADL, sex, hypertension, and ADL were included in the logistic model successively (65.6% concordance; P < 0.001). CONCLUSIONSIn this specific population, impaired geriatric scale scores were found to be associated with classical macrovascular complications, notably using multivariate analyses. This suggests the benefits of thorough screening and management of cognitive and functional decline in elderly type 2 diabetic patients.

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“…Along with cardiovascular risk factors, type 2 diabetes is associated with cognitive decrements, accelerated cognitive decline, and an increased risk for dementia and Alzheimer disease (2,3). A broad range of cognitive domains are affected in type 2 diabetes, and one of the most commonly affected is processing speed (4,5).…”

mentioning

confidence: 99%

Functional Brain Networks Are Altered in Type 2 Diabetes and Prediabetes: Signs for Compensation of Cognitive Decrements? The Maastricht Study

et al. 2016

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Type 2 diabetes is associated with cognitive decrements, accelerated cognitive decline, and increased risk for dementia. Patients with the metabolic syndrome, a major risk factor for diabetes, may display comparable cognitive decrements as seen in type 2 diabetes. Currently, the impact of diabetes and prediabetes on cognition and the underlying organization of functional brain networks still remain to be elucidated. This study investigated whether functional brain networks are affected in type 2 diabetes and prediabetes. Forty-seven participants with diabetes, 47 participants with prediabetes, and 45 control participants underwent detailed cognitive testing and 3-Tesla resting state functional MRI. Graph theoretical network analysis was performed to investigate alterations in functional cerebral networks. Participants with diabetes displayed altered network measures, characterized by a higher normalized cluster coefficient and higher local efficiency, compared with control participants. The network measures of the participants with prediabetes fell between those with diabetes and control participants. Lower processing speed was associated with shorter path length and higher global efficiency. Participants with type 2 diabetes have altered functional brain networks. This alteration is already apparent in the prediabetic stage to a somewhat lower level, hinting at functional reorganization of the cerebral networks as a compensatory mechanism for cognitive decrements.The worldwide prevalence of diabetes is increasing rapidly, with the majority of patients having type 2 diabetes (1). Along with cardiovascular risk factors, type 2 diabetes is associated with cognitive decrements, accelerated cognitive decline, and an increased risk for dementia and Alzheimer disease (2,3). A broad range of cognitive domains are affected in type 2 diabetes, and one of the most commonly affected is processing speed (4,5). However, the underlying pathological mechanism is not yet clear.The progression of normal glucose metabolism to type 2 diabetes is a gradual process in which insulin resistance plays a crucial role. Before the clinical presentation of type 2 diabetes, insulin resistance often is accompanied by other metabolic and vascular abnormalities. The cluster of these cardiovascular risk factors is referred to as the metabolic syndrome and is considered a major risk factor for diabetes (6). Patients with the metabolic syndrome have a high likelihood for diabetes and may display comparable cognitive decrements as seen in patients with type 2 diabetes (5). Furthermore, the cardiovascular risk factors are associated with an increased risk of late-life dementia (7).

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Effects of Type 2 Diabetes on 12-Year Cognitive Change

Cited by 135 publications

References 35 publications

Albuminuria and Cognitive Decline in People with Diabetes and Normal Renal Function

Albuminuria and Cognitive Decline in People with Diabetes and Normal Renal Function

Cardiovascular Events and Geriatric Scale Scores in Elderly (70 Years Old and Above) Type 2 Diabetic Patients at Inclusion in the GERODIAB Cohort

Functional Brain Networks Are Altered in Type 2 Diabetes and Prediabetes: Signs for Compensation of Cognitive Decrements? The Maastricht Study

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