Mild cognitive impairment and progression to dementia in people with diabetes, prediabetes and metabolic syndrome: a systematic review and meta-analysis

Pal, Kingshuk; Mukadam, Naaheed; Petersen, Irene; Cooper, Claudia

doi:10.1007/s00127-018-1581-3

Cited by 187 publications

(141 citation statements)

References 63 publications

Supporting

Mentioning

130

Contrasting

Unclassified

Order By: Relevance

“…The patients in the MCI group exhibited lower BMI, grip strength, muscle mass, fat mass, and walking speed, which were all consistent with the characteristics of sarcopenia (23). Advanced age is a risk factor of MCI in subjects with or without diabetes [6,25]. Elderly diabetes patients are likely to reflect a longer average duration of diabetes and a longer exposure to chronic hyperglycemia and glycemic excursions (7,8,11).…”

Section: Characteristics Of Patients In the MCI Groupsupporting

confidence: 53%

Walking Speed is the Sole Determinant of mild Cognitive Impairment in Japanese Patients with Type 2 Diabetes Mellitus

Machii

Kudo

Saito

et al. 2020

Preprint

View full text Add to dashboard Cite

Background To elucidate the clinical characteristics of type 2 diabetes mellitus patients with mild cognitive impairment (MCI) and to examine whether diagnosis of sarcopenia and/or its criterion are explanatory factors for MCI Methods Patients with type 2 diabetes mellitus were categorized into the MCI group for MoCA-J (the Japanese version of the Montreal cognitive assessment) score <26, and into the non-MCI group for MoCA-J ≥26. Sarcopenia was defined by a low skeletal mass index along with low muscle strength (handgrip strength) or low physical performance (walking speed <1.0 m/s). Univariate and multivariate-adjusted odds ratio models were used to determine the independent contributors for MoCA-J <26. Results Among 438 participants, 221 (50.5%) and 217 (49.5%) comprised the non-MCI and MCI groups, respectively. In the MCI group, age (61 ± 12 vs. 71 ± 10 years, p < 0.01) and duration of diabetes (14 ± 9 vs. 17 ± 9 years, p < 0.01) were higher than those in the non-MCI group. Patients in the MCI group exhibited lower hand grip strength, walking speed, and skeletal mass index, but higher prevalence of sarcopenia. Only walking speed (rather than muscle loss or muscle weakness) was found to be an independent determinant of MCI after adjusting for multiple factors, such as age, gender, BMI, duration of diabetes, hypertension, dyslipidemia, smoking, drinking, eGFR, HbA1c, and history of coronary heart diseases and stroke. In subgroup analysis, a group consisting of male patients aged ≥65 years, with BMI <25, showed a significant OR for walking speed. Conclusions This is the first study to show that slow walking speed is a determinant for the presence of MCI in patients with type 2 diabetes. It was suggested that walking speed is an important factor in the prediction and prevention of MCI development in patients with diabetes mellitus.

show abstract

Section: Characteristics Of Patients In the MCI Groupsupporting

confidence: 53%

Walking Speed is the Sole Determinant of mild Cognitive Impairment in Japanese Patients with Type 2 Diabetes Mellitus

Machii

Kudo

Saito

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Evidence proves that glycosylated haemoglobin (HbA 1c ) can also be a measure of prediabetes . Indeed, there is strong evidence that suggests prediabetes is associated with an increasing risk of stroke, dementia and cognitive impairment . The relationship between prediabetes and different kinds of structural brain abnormalities is still controversial, although similar micro‐ and macrovascular dysfunction were shown to be present .…”

Section: Introductionmentioning

confidence: 99%

Prediabetes and structural brain abnormalities: Evidence from observational studies

Zhou

Tang

Han

et al. 2019

Diabetes Metabolism Res

View full text Add to dashboard Cite

Type 2 diabetes mellitus has been linked to structural brain abnormalities, but evidence of the association among prediabetes and structural brain abnormalities has not been systematically evaluated. Comprehensive searching strategies and relevant studies were systematically retrieved from PubMed, Embase, Medline and web of science. Twelve articles were included overall. Stratified analyses and regression analyses were performed. A total of 104 468 individuals were included.The risk of infarct was associated with continuous glycosylated haemoglobin (HbA 1c ) [adjusted odds ratio (OR) 1.19 (95% confidence interval [CI]: 1.05-1.34)], or prediabetes [adjusted OR 1.13 (95% CI: 1.00-1.27)]. The corresponding ORs associated with white matter hyperintensities were 1.08 (95%CI: 1.04-1.13) for prediabetes, and 1.10 (95%CI: 1.08-1.12) for HbA 1c . The association was significant between the decreased risk of brain volume with continuous HbA 1c (the combined OR 0.92, 95% CI: 0.87-0.98). Grey matter volume and white matter volume were inversely associated with prediabetes [weighted mean deviation (WMD), −9.65 (95%CI: −15.25 to −4.04) vs WMD, −9.25 (95%CI: −15.03 to −3.47)].There were no significant association among cerebral microbleeds, hippocampal volume, continuous total brain volume, and prediabetes. Our findings demonstrated that (a) both prediabetes and continuous HbA 1c were significantly associated with increasing risk of infarct or white matter hyperintensities; (b) continuous HbA 1c was associated with a decreased risk of brain volume; (c) prediabetes was inversely associated with grey matter volume and white matter volume. To confirm these findings, further studies on early diabetes onset and structural brain abnormalities are needed. K E Y W O R D Sglycosylated haemoglobin, meta-analysis, prediabetes, structural brain abnormalities

show abstract

“…4,5 The early prediction of conversion of such impairment to dementia has important clinical considerations. 10 The mild neurocognitive dysfunction caused by diabetes not only complicates the daily activities of patients with diabetes but also doubles the likelihood of such patients developing depression which will further negatively impact the cognitive function and daily activities. 11 Patients with T2DM also have a higher incidence of Alzheimer's disease and increased occurrence of vascular dementia.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 Many studies have implicated that the primary complication of MCI is progression to Alzheimer's disease possibly due to hyperlipidemia (seen in T2DM) which augments the risk of vascular dysfunction. 5,10,12 Although some research has been done with regard to cognitive dysfunction in patients with diabetes, more insightful research is needed to understand the mechanisms and natural course of such a complication in order to better develop strategies for its prevention and treatment. Over the years newer modalities like neurocognitive testing, evoked response potentials and also magnetic resonance imaging are being used to investigate the effect of diabetes on the brain.…”

Section: Discussionmentioning

confidence: 99%

Association of Cognitive Impairment and Type 2 Diabetes Mellitus: A Case-Control Study

Rama¹,

Rajesh²

2019

IJCMR

View full text Add to dashboard Cite

Introduction: Patients with type 2 diabetes mellitus (T2DM) have cognitive deficits that can be attributed to their disease. Mild cognitive impairment (MCI) is a transitional phase between the cognitive decline that is expected due to the normal aging process and the more disconcerting decline of dementia. This case-control study aimed to explore the association between type 2 diabetes mellitus and mild cognitive impairment and compare the prevalence of mild cognitive impairment between non-diabetics and type 2 diabetics. Material and Methods: 50 patients with T2DM and 50 age and sex matched non-diabetic controls were selected for the study. Demographic data and medical history was collected by face to face interview following which the Mini-Mental state examination (MMSE) and the Montreal Cognitive Assesment (MoCA) were conducted. If either of the screening instruments suggested MCI, the patient was then subjected to an extensive medical examination conducted by qualified medical clinicians blinded to the MMSE and MoCA scores for a more detailed diagnosis of MCI. Chi square test was performed to determine if T2DM was significantly correlated with MCI. Linear regression was performed to determine the strength of years of illness as a predictor of MMSE and MoCA score. Results: Chi square test revealed a statistically significant correlation between T2DM and MCI. Years of illness was found to predict 5% of the variance in MMSE score and 14% of the variance in MoCA score. Conclusion: The study established that mild cognitive impairment had a significant statistical association with T2DM.

show abstract

Mild cognitive impairment and progression to dementia in people with diabetes, prediabetes and metabolic syndrome: a systematic review and meta-analysis

Cited by 187 publications

References 63 publications

Walking Speed is the Sole Determinant of mild Cognitive Impairment in Japanese Patients with Type 2 Diabetes Mellitus

Walking Speed is the Sole Determinant of mild Cognitive Impairment in Japanese Patients with Type 2 Diabetes Mellitus

Prediabetes and structural brain abnormalities: Evidence from observational studies

Association of Cognitive Impairment and Type 2 Diabetes Mellitus: A Case-Control Study

Contact Info

Product

Resources

About