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Cited by 313Dementia and Cognitive Impairment ResearchDiabetes Treatment and ManagementDiabetes Management and Research

Diabetes, glucose control, and 9-year cognitive decline among older adults without dementia

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Yaffe, Kristine, Falvey, Cherie, Hamilton, Nathan, Schwartz, Ann V., Simonsick, Eleanor M., Satterfield, Suzanne, Cauley, Jane A., Rosano, Caterina +3 more·2012·Archives of Neurology
DOI 10.1001/archneurol.2012.1117PMC PMC3752423
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Abstract

OBJECTIVES: To determine if prevalent and incident diabetes mellitus (DM) increase risk of cognitive decline and if, among elderly adults with DM, poor glucose control is related to worse cognitive performance. DESIGN Prospective cohort study. SETTING: Health, Aging, and Body Composition Study at 2 community clinics. PARTICIPANTS: A total of 3069 elderly adults (mean age, 74.2 years; 42% black; 52% female). MAIN OUTCOME MEASURES: Participants completed the Modified Mini-Mental State Examination (3MS) and Digit Symbol Substitution Test (DSST) at baseline and selected intervals over 10 years. Diabetes mellitus status was determined at baseline and during follow-up visits. Glycosylated hemoglobin A1c level was measured at years 1 (baseline), 4, 6, and 10 from fasting whole blood. RESULTS: At baseline, 717 participants (23.4%) had prevalent DM and 2352 (76.6%) were without DM, 159 of whom developed incident DM during follow-up. Participants with prevalent DM had lower baseline test scores than participants without DM (3MS: 88.8 vs 90.9; DSST: 32.5 vs 36.3, respectively; t = 6.09; P = .001 for both tests). Results from mixed-effects models showed a similar pattern for 9-year decline (3MS: -6.0- vs -4.5-point decline; t = 2.66; P = .008; DSST: -7.9- vs -5.7-point decline; t = 3.69; P = .001, respectively). Participants with incident DM tended to have baseline and 9-year decline scores between the other 2 groups but were not statistically different from the group without DM. Multivariate adjustment for demographics and medical comorbidities produced similar results. Among participants with prevalent DM, glycosylated hemoglobin A1c level was associated with lower average mean cognitive scores (3MS: F = 8.2; P for overall = .003; DSST: F = 3.4; P for overall = .04), even after multivariate adjustment. CONCLUSION: Among well-functioning older adults, DM and poor glucose control among those with DM are associated with worse cognitive function and greater decline. This suggests that severity of DM may contribute to accelerated cognitive aging.

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  • Poor glycemic management is associated with a decline in cognitive function.

    “Poor glycemic management is associated with a decline in cognitive function (15,16), and longer duration of diabetes is associated with worsening cognitive function.”

    From 13. Older Adults: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [15]

  • Longer duration of diabetes is associated with worsening cognitive function.

    “Poor glycemic management is associated with a decline in cognitive function (15,16), and longer duration of diabetes is associated with worsening cognitive function.”

    From 13. Older Adults: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [15]

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Research works printed but not linked: 24

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Authors
Yaffe, K., Falvey, C., Hamilton, N., Schwartz, A. V., Simonsick, E. M., Satterfield, S., Cauley, J. A., Rosano, C., Launer, L. J., Strotmeyer, E. S., & Harris, T. B.
Affiliations
  • University of California, San Francisco (US)
  • University of Tennessee Health Science Center (US)
  • National Institutes of Health (US)
  • San Francisco VA Medical Center (US)
  • University of Pittsburgh (US)
Corresponding author
Yaffe, Kristine
ORCID
Venue
Archives of Neurology
Publisher
American Medical Association (AMA)
Published
2012-09-01
Volume
69
Issue
9
Pages
1170-5
ISSN
0003-9942 (ISSN-L)
DOI
10.1001/archneurol.2012.1117
PMC
PMC3752423
OpenAlex
W2101868057
Cited by
313
References
6
Citations by year
2026: 11 · 2025: 12 · 2024: 13 · 2023: 16 · 2022: 12 · 2021: 28 · 2020: 22 · 2019: 27 · 2018: 31 · 2017: 18 · 2016: 30 · 2015: 31 · 2014: 36 · 2013: 22 · 2012: 3
FWCI
21.02
Type
journal article
Language
en
Open access
Locations
  • Archives of Neurology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • D-Scholarship@Pitt (University of Pittsburgh) (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • U.S. Department of Defense
  • American Health Assistance Foundation
  • Amgen
  • Pfizer
  • GlaxoSmithKline
  • National Institutes of Health (N01-AG-6-2103, n01ag062101-007, n01ag062103-006, N01‐AG‐6‐2106, n01ag062106-007, N01-AG-6-2101)
  • National Institute on Aging (N01‐AG‐6–2101, R01‐NR012459, R01AG028050, K24AG031155, N01 AG062106, N01AG62106, N01-AG-62103, N01 AG062103, N01 AG062101)
  • National Institute of Mental Health (N01-AG-6-2101, N01-AG-6-2106, R01-NR012459, R01-AG028050)
  • National Institute of Nursing Research (N01-AG-6–2101, N01-AG-6-2103, N01-AG-6–2106, R01NR012459)
  • National Institute of Diabetes and Digestive and Kidney Diseases
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
diabetes mellitus, glycemic control, cognitive decline, older adults, glycosylated hemoglobin A1c, new-onset diabetes, cognitive aging, cognitive function, diabetes severity, Health, Aging, and Body Composition Study, community-dwelling older adults, sex differences, racial differences, socioeconomic status, physical activity, body mass index, alcohol consumption
MeSH terms
Aged, Aged, 80 and over, Aging, Blood Glucose, Cognition, Cognition Disorders, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Humans, Longitudinal Studies, Male, Neuropsychological Tests, Prospective Studies, Risk, Self Report

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