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The Relationship between Impaired Glucose Tolerance, Type 2 Diabetes, and Cognitive Function
Abstract
The present review integrates findings of published studies that have evaluated the cognitive function of treated and untreated type 2 diabetic patients and provides a detailed overview of the neuropsychological assessments conducted. Cognitive deficits are observed in older people with glucose intolerance or untreated diabetes but these deficits appear to be attenuated by treatments that improve glycemic control. Cognitive decrements in treated type 2 diabetic patients are most consistently observed on measures of verbal memory (35% of the measures) and processing speed (45% of the measures) while preserved function is observed on measures of visuospatial, attention, semantic and language function. Some studies suggest that deficits in cognitive functions are associated with poorer glycemic control. A number of other factors, such as depression, cardiovascular and cerebrovascular disease, increase these deficits. We conclude that, in diabetic patients who achieve and maintain good glycemic control, type 2 diabetes only has a small impact on cognitive functions before the age of 70 years. However, early onset of type 2 diabetes, poor glycemic control and the presence of micro- and macrovascular disease may interact to produce early cognitive deficits. In older adults (70 years and over), diabetes likely interacts with other dementing processes such as vascular disease and Alzheimer's disease to hasten cognitive decline.
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“The mechanisms for this association likely involve the return of comorbid medical conditions that adversely impact cognitive function (e.g., hypertension, diabetes, sleep apnea) or even from the independent effects of adiposity.28–31”
From Cognitive Function After Bariatric Surgery: Evidence for Improvement 3 Years After Surgery (2014) · cites this paper as [29]
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“Indeed, only one [7] of the review articles that summarised the available data pertaining to this relationship [4, 6 -11] provided a quantitative estimate.”
From Cognitive decline and dementia in diabetes—systematic overview of prospective observational studies (2005) · cites this paper as [7]
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Metadata
- Authors
- Awad, N., Gagnon, M., & Messier, C.
- Affiliations
- University of Ottawa (CA)
- Institute of Mental Health Research (CA)
- ORCID
- Messier, Claude
- Venue
- Journal of Clinical and Experimental Neuropsychology
- Publisher
- Informa UK Limited
- Published
- 2004-11
- Volume
- 26
- Issue
- 8
- Pages
- 1044-1080
- ISSN
- 0165-0475 (ISSN-L)
- 1380-3395
- 1744-411X
- OpenAlex
- W2025771431
- Cited by
- 551
- References
- 174
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 14 · 2023: 12 · 2022: 15 · 2021: 12 · 2020: 47 · 2019: 29 · 2018: 18 · 2017: 29 · 2016: 32 · 2015: 22 · 2014: 35 · 2013: 36 · 2012: 31
- FWCI
- 11.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical and Experimental Neuropsychology (publishedVersion)
- PubMed (publishedVersion)
- 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 › Oncology › Cancer-related cognitive impairment studies
- Keywords
- type 2 diabetes, impaired glucose tolerance, cognitive function, glycemic control, verbal memory, processing speed, depression, cardiovascular disease, cerebrovascular disease, microangiopathy, macroangiopathy, Alzheimer's disease, vascular dementia, cognitive decline, older adults
- MeSH terms
- Cognition, Cognition Disorders, Dementia, Diabetes Mellitus, Type 2, Humans, Intelligence Tests, Longitudinal Studies, Neuropsychological Tests, Glucose Intolerance, Diabetes Complications
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