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Cited by 93Dementia and Cognitive Impairment ResearchDiabetes Treatment and ManagementPharmaceutical Practices and Patient Outcomes

Rosiglitazone and Cognitive Stability in Older Individuals With Type 2 Diabetes and Mild Cognitive Impairment

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Abbatecola, Angela M., Lattanzio, Fabrizia, Molinari, Anna M., Cioffi, Michele, Mansi, Luigi, Rambaldi, Pierfrancesco, DiCioccio, Luigi, Cacciapuoti, Federico +2 more·2010·Diabetes Care
DOI 10.2337/dc09-2030PMC PMC2909046
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Abstract

OBJECTIVE: Studies have suggested that insulin resistance plays a role in cognitive impairment in individuals with type 2 diabetes. We aimed to determine whether an improvement in insulin resistance could explain cognitive performance variations over 36 weeks in older individuals with mild cognitive impairment (MCI) and type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 97 older individuals (mean ± SD age 76 ± 6 years) who had recently (<2 months) started an antidiabetes treatment of metformin (500 mg twice a day) (n = 30) or metformin (500 mg/day)+rosiglitazone (4 mg/day) (n = 32) or diet (n = 35) volunteered. The neuropsychological test battery consisted of the Mini-Mental State Examination (MMSE), Rey Verbal Auditory Learning Test (RAVLT) total recall, and Trail Making Tests (TMT-A and TMT-B) performed at baseline and every 12 weeks for 36 weeks along with clinical testing. RESULTS: At baseline, no significant differences were found between groups in clinical or neuropsychological parameters. Mean ± SD values in the entire population were as follows: A1C 7.5 ± 0.5%, fasting plasma glucose (FPG) 8.6 ± 1.3 mmol/l, fasting plasma insulin (FPI) 148 ± 74 pmol/l, MMSE 24.9 ± 2.4, TMT-A 61.6 ± 42.0, TMT-B 162.8 ± 78.7, the difference between TMT-B and TMT-A [DIFFBA] 101.2 ± 58.1, and RAVLT 24.3 ± 2.1. At follow-up, ANOVA models tested changes in metabolic control parameters (FPI, FPG, and A1C). Such parameters improved in the metformin and metformin/rosiglitazone groups (Ptrend < 0.05 in both groups). ANCOVA repeated models showed that results for the metformin/rosiglitazone group remained stable for all neuropsychological tests, and results for the diet group remained stable for the MMSE and TMT-A and declined for the TMT-B (Ptrend = 0.024), executive efficiency (DIFFBA) (Ptrend = 0.026), and RAVLT memory test (Ptrend = 0.011). Results for the metformin group remained stable for the MMSE and TMTs but declined for the RAVLT (Ptrend = 0.011). With use of linear mixed-effects models, the interaction term, FPI × time, correlated with cognitive stability on the RAVLT in the metformin/rosiglitazone group (β = −1.899; P = 0.009). CONCLUSIONS: Rosiglitazone may protect against cognitive decline in older individuals with type 2 diabetes and MCI.

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Authors
Abbatecola, A. M., Lattanzio, F., Molinari, A. M., Cioffi, M., Mansi, L., Rambaldi, P., DiCioccio, L., Cacciapuoti, F., Canonico, R., & Paolisso, G.
Affiliations
  • Istituto Nazionale di Riposo e Cura per Anziani (IT)
  • University of Campania "Luigi Vanvitelli" (IT)
  • Department of General Pathology, Second University of Naples, Naples, Italy;
  • Department of Geriatric Medicine, “Santa Scolastica” Hospital, Cassino, Italy;
Corresponding author
Paolisso, Giuseppe
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2010-04-30
Volume
33
Issue
8
Pages
1706-1711
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc09-2030
PMC
PMC2909046
OpenAlex
W2143770895
Cited by
93
References
25
Citations by year
2026: 1 · 2025: 7 · 2024: 7 · 2023: 5 · 2022: 3 · 2021: 6 · 2020: 7 · 2019: 7 · 2018: 4 · 2017: 4 · 2016: 7 · 2015: 8 · 2014: 9 · 2013: 3 · 2012: 8
FWCI
3.94
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes Care (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli" (submittedVersion)
Funders
  • GlaxoSmithKline
  • Seconda Università degli Studi di Napoli
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 › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
Keywords
rosiglitazone, metformin, type 2 diabetes, mild cognitive impairment, insulin resistance, cognitive stability, executive function, older adults, fasting insulin, glycemic control, Trail Making Test, Rey Auditory Verbal Learning Test, Mini-Mental State Examination, cognitive decline prevention, PPARγ agonists, insulin sensitizers
MeSH terms
Rosiglitazone, Aged, Aged, 80 and over, Cognition, Diabetes Mellitus, Type 2, Female, Humans, Hypoglycemic Agents, Male, Thiazolidinediones

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