The utility of brief cognitive tests for patients with type 2 diabetes mellitus: a systematic review
Abstract
Background Type 2 diabetes mellitus (T2DM) is associated with an increased risk for mild cognitive impairment and dementia in both middle-aged and older individuals. Brief cognitive tests can potentially serve as a reliable and cost effective approach to detect for cognitive decrements in clinical practice.Objective This systematic review examined the utility of brief cognitive tests in studies with patients with T2DM.Method This systematic review was conducted according to guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. "PubMed," "PsychINFO," "ScienceDirect," and "ProQuest" electronic databases were searched to identify articles published from January 1, 2005 to December 31, 2015.Results The search yielded 22 studies, with only 8 using brief tests as a cognitive screening tool, whereas the majority using these tests as a measure of global cognitive functions. In regard to cognitive screening studies, most had failed to fulfil the standard reporting of diagnostic test accuracy criteria such as Standards for Reporting of Diagnostic Accuracy for dementia and cognitive impairment. Moreover, few studies reported discriminant indices such as sensitivity, specificity, and positive and negative predictive values of brief cognitive tests in detecting cognitive impairment in patients with T2DM. Among studies which used brief cognitive tests as a measure of global cognitive function, patients with diabetes tended to perform worse than patients without diabetes. Processing speed appeared to be particularly impaired among patients with diabetes, therefore, measures of processing speed such as the Digit Symbol Substitution Test may add value to brief cognitive tests such as the Montreal Cognitive Assessment.Conclusions The Montreal Cognitive Assessment supplemented by the Digit Symbol Substitution Test indicate initial promise in screening for cognitive impairment in T2DM.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The ability of the DSST to detect deterioration in processing speed has been useful as a complementary cognitive assessment in the screening of patients with diabetes mellitus type 2.
“The ability of the DSST to detect deterioration in processing speed has also been useful as a complementary cognitive assessment in the screening of patients with diabetes mellitus type 2.30”
From Digit Symbol Substitution Test: The Case for Sensitivity Over Specificity in Neuropsychological Testing (2018) · cites this paper as [30]
In both middle-aged and older persons, diabetes mellitus type 2 is associated with an increased risk of mild cognitive impairment and dementia.
“In both middle-aged and older persons, diabetes mellitus type 2 has been found to be associated with an increased risk of mild cognitive impairment and dementia.30”
From Digit Symbol Substitution Test: The Case for Sensitivity Over Specificity in Neuropsychological Testing (2018) · cites this paper as [30]
Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823 · see citing works
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
(2009) · PubMed Central · Cited by 44,859 · see citing works
Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & the PRISMA Group* (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-4-200908180-00135 · Cited by 37,554 · see citing works
Risk of dementia in diabetes mellitus: a systematic review
Biessels, G. J., Staekenborg, S., Brunner, E., Brayne, C., & Scheltens, P. (2006) · The Lancet Neurology · doi:10.1016/s1474-4422(05)70284-2 · Cited by 2,187 · see citing works
Cheng, G., Huang, C., Deng, H., & Wang, H. (2012) · Internal Medicine Journal · doi:10.1111/j.1445-5994.2012.02758.x · Cited by 1,040 · see citing works
Cognitive Dysfunction and Diabetes Mellitus
Kodl, C. T., & Seaquist, E. R. (2008) · Endocrine Reviews · doi:10.1210/er.2007-0034 · Cited by 823 · see citing works
Tariq, S. H., Tumosa, N., Chibnall, J. T., Perry, M. H., & Morley, J. E. (2006) · The American Journal of Geriatric Psychiatry · doi:10.1097/01.jgp.0000221510.33817.86 · Cited by 724 · see citing works
Initiative, A. D. N., Trzepacz, P. T., Hochstetler, H. M., Wang, S., Walker, B., & Saykin, A. J. (2015) · BMC Geriatrics · doi:10.1186/s12877-015-0103-3 · Cited by 616 · see citing works
Launer, L. J., Miller, M. E., Williamson, J. D., Lazar, R. M., Gerstein, H. C., Murray, A. M., Sullivan, M., Horowitz, K. R., Ding, J., Marcovina, S., et al. (2011) · The Lancet Neurology · doi:10.1016/s1474-4422(11)70188-0 · Cited by 574 · see citing works
Biessels, G. J., Strachan, M. W. J., Visseren, F. L. J., Kappelle, L. J., & Whitmer, R. A. (2013) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(13)70088-3 · Cited by 555 · see citing works
The relationship between impaired glucose tolerance, type 2 diabetes, and cognitive function
Awad, N., Gagnon, M., & Messier, C. (2004) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803390490514875 · Cited by 551 · see citing works
Ageing and diabetes: implications for brain function
Biessels, G. J., van der Heide, L. P., Kamal, A., Bleys, R. L. A. W., & Gispen, W. H. (2002) · European Journal of Pharmacology · doi:10.1016/s0014-2999(02)01486-3 · Cited by 458 · see citing works
Palta, P., Schneider, A. L. C., Biessels, G. J., Touradji, P., & Hill-Briggs, F. (2014) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617713001483 · Cited by 364 · see citing works
Diabetes, glucose control, and 9-year cognitive decline among older adults without dementia
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., et al. (2012) · Archives of Neurology · doi:10.1001/archneurol.2012.1117 · Cited by 313 · see citing works
A 4 year follow-up study of cognitive functioning in patients with type 2 diabetes mellitus
on behalf of the Utrecht Diabetic Encephalopathy Study Group, van den Berg, E., Reijmer, Y. D., de Bresser, J., Kessels, R. P. C., Kappelle, L. J., & Biessels, G. J. (2009) · Diabetologia · doi:10.1007/s00125-009-1571-9 · Cited by 256 · see citing works
Kanaya, A. M., Barrett-Connor, E., Gildengorin, G., & Yaffe, K. (2004) · Archives of Internal Medicine · doi:10.1001/archinte.164.12.1327 · Cited by 255 · see citing works
Cognitive dysfunction in patients with type 2 diabetes
Reijmer, Y. D., van den Berg, E., Ruis, C., Kappelle, L. J., & Biessels, G. J. (2010) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.1112 · Cited by 251 · see citing works
Type 2 Diabetes and Cognitive Function in Community-Dwelling Elderly Women
Grodstein, F., Chen, J., Wilson, R. S., & Manson, J. E. (2001) · Diabetes Care · doi:10.2337/diacare.24.6.1060 · Cited by 223 · see citing works
Impact of impaired glucose tolerance and type 2 diabetes on cognitive aging
Messier, C. (2005) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2005.09.014 · Cited by 207 · see citing works
Screening for mild cognitive impairment: a systematic review
Lonie, J. A., Tierney, K. M., & Ebmeier, K. P. (2009) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2208 · Cited by 195 · see citing works
Reporting standards for studies of diagnostic test accuracy in dementia
Noel-Storr, A. H., McCleery, J. M., Richard, E., Ritchie, C. W., Flicker, L. A., Cullum, S. J., Davis, D. H. J., Quinn, T. J., Hyde, C., Rutjes, A. W., et al. (2014) · Neurology · doi:10.1212/wnl.0000000000000621 · Cited by 194 · see citing works
Spencer, R. J., Wendell, C. R., Giggey, P. P., Katzel, L. I., Lefkowitz, D. M., Siegel, E. L., & Waldstein, S. R. (2013) · Experimental Aging Research · doi:10.1080/0361073x.2013.808109 · Cited by 169 · see citing works
Postprandial plasma glucose excursions and cognitive functioning in aged type 2 diabetics
Abbatecola, A. M., Rizzo, M. R., Barbieri, M., Grella, R., Arciello, A., Laieta, M. T., Acampora, R., Passariello, N., Cacciapuoti, F., & Paolisso, G. (2006) · Neurology · doi:10.1212/01.wnl.0000224760.22802.e8 · Cited by 169 · see citing works
Cognition in the Early Stage of Type 2 Diabetes
Ruis, C., Biessels, G. J., Gorter, K. J., van den Donk, M., Kappelle, L. J., & Rutten, G. E. H. M. (2009) · Diabetes Care · doi:10.2337/dc08-2143 · Cited by 164 · see citing works
Okereke, O. I., Kang, J. H., Cook, N. R., Gaziano, J. M., Manson, J. E., Buring, J. E., & Grodstein, F. (2008) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2008.01686.x · Cited by 155 · see citing works
Bruce, D. G., Casey, G. P., Grange, V., Clarnette, R. C., Almeida, O. P., Foster, J. K., Ives, F. J., & Davis, T. M. E. (2003) · Diabetes Research and Clinical Practice · doi:10.1016/s0168-8227(03)00084-6 · Cited by 145 · see citing works
Memory and executive functions in persons with type 2 diabetes: a meta‐analysis
Sadanand, S., Balachandar, R., & Bharath, S. (2016) · Diabetes/Metabolism Research Reviews · doi:10.1002/dmrr.2664 · Cited by 141 · see citing works
Alagiakrishnan, K., Zhao, N., Mereu, L., Senior, P. A., & Senthilselvan, A. (2013) · BioMed Research International · doi:10.1155/2013/186106 · Cited by 139 · see citing works
Malmstrom, T. K., Voss, V. B., Cruz‐Oliver, D. M., Cummings‐Vaughn, L. A., Tumosa, N., Grossberg, G. T., & Morley, J. E. (2015) · The journal of nutrition health & aging · doi:10.1007/s12603-015-0564-2 · Cited by 135 · see citing works
van den Berg, E., de Craen, A. J. M., Biessels, G. J., Gussekloo, J., & Westendorp, R. G. J. (2006) · Diabetologia · doi:10.1007/s00125-006-0333-1 · Cited by 126 · see citing works
Exploring effects of type 2 diabetes on cognitive functioning in older adults.
Yeung, S. E., Fischer, A. L., & Dixon, R. A. (2009) · Neuropsychology · doi:10.1037/a0013849 · Cited by 121 · see citing works
Inflammation-associated declines in cerebral vasoreactivity and cognition in type 2 diabetes
Chung, C., Maldonado, D. P., Jor’dan, A. J., Hao, Y., Milberg, W., & Novak, V. (2015) · Neurology · doi:10.1212/wnl.0000000000001820 · Cited by 108 · see citing works
Abbatecola, A. M., Lattanzio, F., Molinari, A. M., Cioffi, M., Mansi, L., Rambaldi, P., DiCioccio, L., Cacciapuoti, F., Canonico, R., & Paolisso, G. (2010) · Diabetes Care · doi:10.2337/dc09-2030 · Cited by 93 · see citing works
Hugenschmidt, C. E., Lovato, J. F., Ambrosius, W. T., et al. (2014) · Diabetes Care · doi:10.2337/dc14-0502 · Cited by 81 · see citing works
Dore, G. A., Elias, M. F., Robbins, M. A., Elias, P. K., & Nagy, Z. (2009) · Diabetologia · doi:10.1007/s00125-009-1497-2 · Cited by 81 · see citing works
Investigation on the relationship between diabetes mellitus type 2 and cognitive impairment
Ebady, S. A., Arami, M. A., & Shafigh, M. H. (2008) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2008.08.020 · Cited by 75 · see citing works
Cognitive impairment in type 2 diabetes mellitus
Hazari, M. A. H., Reddy, B. R., Uzma, N., & Kumar, B. S. (2011) · International Journal of Diabetes Mellitus · doi:10.1016/j.ijdm.2011.01.001 · Cited by 72 · see citing works
West, R. K., Ravona‐Springer, R., Schmeidler, J., LeRoith, D., Koifman, K., Guerrero‐Berroa, E., Preiss, R., Hoffman, H., Silverman, J. M., Heymann, A. D., et al. (2014) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2014.01.010 · Cited by 62 · see citing works
Cao, L., Hai, S., Lin, X., et al. (2012) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2012.05.003 · Cited by 57 · see citing works
Zhang, Y.-W., Zhang, J., Liu, C., Wei, P., Zhang, X., Yuan, Q., Yin, X., Wei, L., Cui, J., & Wang, J. (2015) · Chinese Medical Journal · doi:10.4103/0366-6999.151082 · Cited by 57 · see citing works
Sinclair, A. J., Gadsby, R., Hillson, R., Forbes, A., & Bayer, A. J. (2013) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2013.01.001 · Cited by 52 · see citing works
Wang, C., Fu, K., Liu, H., Xing, F., & Zhang, S. (2014) · PLoS ONE · doi:10.1371/journal.pone.0108883 · Cited by 50 · see citing works
Christman, A. L., Vannorsdall, T. D., Pearlson, G. D., Hill‐Briggs, F., & Schretlen, D. J. (2009) · Archives of Clinical Neuropsychology · doi:10.1093/arclin/acp091 · Cited by 48 · see citing works
Kaya, D., Işık, A. T., Usarel, C., Soysal, P., Ellıdokuz, H., & Grossberg, G. T. (2016) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2015.12.093 · Cited by 46 · see citing works
On the Interplay of Microvasculature, Parenchyma, and Memory in Type 2 Diabetes
van Bussel, F. C. G., Backes, W. H., Hofman, P. A. M., van Oostenbrugge, R. J., Kessels, A. G. H., van Boxtel, M. P. J., Schram, M. T., Stehouwer, C. D. A., Wildberger, J. E., & Jansen, J. F. A. (2015) · Diabetes Care · doi:10.2337/dc14-2043 · Cited by 39 · see citing works
Koekkoek, P. S., Rutten, G. E. H. M., van den Berg, E., van Sonsbeek, S., Gorter, K. J., Kappelle, L. J., & Biessels, G. J. (2013) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2013.02.028 · Cited by 29 · see citing works
Clinical backgrounds and morbidity of cognitive impairment in elderly diabetic patients
Yasunori, Y., Miwa, T., Sakurai, H., Hanyu, H., Iwamoto, T., & Odawara, M. (2011) · Endocrine Journal · doi:10.1507/endocrj.k10e-388 · Cited by 27 · see citing works
Functional Living in Older Adults With Type 2 Diabetes
Smith, M., Else, J. E., Paul, L., Foster, J. K., Walker, M., Wesnes, K. A., & Riby, L. M. (2014) · Journal of Aging and Health · doi:10.1177/0898264314534896 · Cited by 26 · see citing works
Wang, Y., Xu, X.-Y., Feng, C.-H., Li, Y.-L., Ge, X., Zong, G., Wang, Y., Feng, B., & Zhang, P. (2015) · Metabolic Brain Disease · doi:10.1007/s11011-015-9670-4 · Cited by 25 · see citing works
Wennberg, A. M. V., Gottesman, R. F., Kaufmann, C. N., Albert, M., Chen-Edinboro, L. P., Rebok, G. W., Kasper, J. D., & Spira, A. P. (2014) · International Psychogeriatrics · doi:10.1017/s1041610214001380 · Cited by 24 · see citing works
Performance of the NINDS-CSN 5-Minute Protocol in a National Population-Based Sample
Kennedy, R., Wadley, V. G., McClure, L. A., Letter, A. J., Unverzagt, F. W., Crowe, M. G., Nyenhius, D., Kelley, B. J., Kana, B., Marceaux, J. C., et al. (2014) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617714000733 · Cited by 18 · see citing works
Investigation the Cognitive Impairment in Diabetes Mellitus Type 2 with Moca Test
(2014) · African Journal of Psychiatry · doi:10.4172/psychiatry.1000166 · Cited by 7 · see citing works
Lai, Y., Yang, Y., Tsai, M.-L., Huang, C., & Chiou, J. (2014) · International Psychogeriatrics · doi:10.1017/s1041610214000908 · Cited by 6 · see citing works
Diabetes mellitus and cognitive functioning in a Serbian sample
Djokic, B., Spitznagel, M. B., Pavlović, D. M., Janković, N., Parojčić, A., Ilić, V. L., & Djurovic, M. N. (2014) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803395.2014.985190 · Cited by 4 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Jaeger, J. (2018) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000941 · Cited by 836 · see citing works
- Authors
- Dong, Y., Kua, Z. J., Khoo, E. Y. H., Koo, E. H., & Merchant, R. A.
- Affiliations
- National University of Singapore (SG)
- The University of Queensland (AU)
- Corresponding author
- Dong, YanHong
- Venue
- Journal of the American Medical Directors Association
- Publisher
- Elsevier BV
- Published
- 2016-10
- Volume
- 17
- Issue
- 10
- Pages
- 889-895
- ISSN
- 1525-8610 (ISSN-L)
- OpenAlex
- W2489825929
- Cited by
- 29
- References
- 54
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 6 · 2023: 2 · 2022: 1 · 2021: 4 · 2020: 2 · 2019: 2 · 2018: 1 · 2017: 4 · 2016: 2
- FWCI
- 0.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Medical Directors Association (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Saint Louis University
- National University Health System
- National Institute of Neurological Disorders and Stroke
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Keywords
- type 2 diabetes, brief cognitive tests, cognitive screening, dementia, Montreal Cognitive Assessment, Digit Symbol Substitution Test, processing speed, diagnostic accuracy, sensitivity and specificity, global cognitive function
- MeSH terms
- Adult, Aged, Cognition Disorders, Diabetes Mellitus, Type 2, Female, Humans, Male, Middle Aged, Neuropsychological Tests
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
