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Is Type II Diabetes Associated With an Increased Risk of Cognitive Dysfunction?: A critical review of published studies
Abstract
Type II (non-insulin-dependent) diabetes may be associated with impaired cognitive function. A detailed search of the literature has identified 19 controlled studies in which cognitive function in type II diabetes has been examined. The studies vary widely with respect to the nature of the diabetic populations studied and the psychological tests used. Thirteen studies demonstrated that the diabetic individuals performed more poorly in at least one aspect of cognitive function. The most commonly affected cognitive ability was verbal memory. Psychomotor ability and frontal lobe function were affected less consistently. The remaining six studies showed no differences in cognitive ability between subjects with type II diabetes and nondiabetic control subjects, but none had adequate statistical power to detect a between-group difference in cognitive ability of 0.5 of a standard deviation (a medium effect size). These findings are consistent with type II diabetes being associated with an increased risk of cognitive dysfunction. However, the widespread differences in methodology between the studies should lead to a cautious interpretation of their conclusions. The etiology of any cognitive decrement in type II diabetes is likely to result from an interaction between metabolic abnormalities intrinsic to diabetes, diabetes-specific complications, and other diabetes-related disorders.
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“There is a growing literature indicating that individuals with diabetes have impairments in recent memory (3–6).”
From Reduced glucose tolerance is associated with poor memory performance and hippocampal atrophy among normal elderly (2003) · cites this paper as [5]
In the citing paper
“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 [10]
In the citing paper
“As these domains may be selectively impaired in people with diabetes the MMSE/3MS will underestimate the impact of diabetes on cognitive function [10].”
From Cognitive decline and dementia in diabetes—systematic overview of prospective observational studies (2005) · cites this paper as [10]
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“Consequently, it is evident from the literature that type II diabetes is associated with an increased risk of cognitive dysfunction (Strachan et al., 1997; Ryan and Geckle, 2000; Gallacher et al., 2005).”
BackgroundResultInfluentialCognitive outcome following kidney transplantation
Gelb, S. R., Shapiro, R. J., Hill, A., et al. (2007) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfm659 · Cited by 56
Sünram‐Lea, S. I., & Owen, L. (2017) · Proceedings of The Nutrition Society · doi:10.1017/s0029665117000829 · Cited by 61
Erichsen, J. M., Fadel, J. R., & Reagan, L. P. (2021) · Neuropharmacology · doi:10.1016/j.neuropharm.2021.108877 · Cited by 58
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Preserved LTP and water maze learning in hyperglycaemic–hyperinsulinemic ZDF rats
BELANGER, A., LAVOIE, N., Trudeau, F., Massicotte, G., & Gagnon, S. (2004) · Physiology & Behavior · doi:10.1016/j.physbeh.2004.08.031 · Cited by 54
“One of the cognitive functions that seems the most reliably altered in T2D is memory for verbal information [3].”
BackgroundTournoy, J., Lee, D. M., Pendleton, N., O’Neill, T. W., O'Connor, D. B., Bártfai, G., Casanueva, F. F., Finn, J. D., Forti, G., Giwercman, A., et al. (2010) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.1144 · Cited by 53
“Several studies have reported that the metabolic syndrome, or its individual components, may be associated with specific areas of cognition that we did not assess, such as verbal learning and semantic memory [27,28].”
BackgroundC‐peptide and Central Nervous System Complications in Diabetes
Li, Z.-G., & Sima, A. A. F. (2003) · Journal of Diabetes Research · doi:10.1080/15438600490424550 · Cited by 53
“Cognitive deficits (Gradman et al., 1993; Perlmuter et al., 1984; Ryan and Geckle, 2000a; Strachan et al., 1997; Tun et al., 1990; Worrall et al., 1993) and poor performance in abstract reasoning and complex psychomotor functioning (Reaven et al.”
Evidence of Exacerbated Cognitive Deficits in Schizophrenia Patients With Comorbid Diabetes
Dickinson, D., Gold, J. M., Dickerson, F., Medoff, D. R., & Dixon, L. B. (2008) · Psychosomatics · doi:10.1176/appi.psy.49.2.123 · Cited by 52
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Impaired Insulin Signaling and Mechanisms of Memory Loss
Bloemer, J., Bhattacharya, S., Amin, R., & Suppiramaniam, V. D. (2014) · Progress in molecular biology and translational science · doi:10.1016/b978-0-12-800101-1.00013-2 · Cited by 52
Short-term longitudinal trends in cognitive performance in older adults with type 2 diabetes
Fischer, A. L., de Frias, C. M., Yeung, S. E., & Dixon, R. A. (2009) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803390802537636 · Cited by 51
“Fourth, longitudinal studies are vulnerable to survivor bias, as those individuals with lower levels of cognition at baseline are more likely to have dropped out or died (Allen et al., 2004), and retest effects could apply (Strachan et al., 1997).”
Role of Dietary and Endogenous Antioxidants in Diabetes
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Cognitive and Physical Disabilities and Aging-Related Complications of Diabetes
Gregg, E. W., & Brown, A. F. (2003) · Clinical Diabetes · doi:10.2337/diaclin.21.3.113 · Cited by 51
Structural brain imaging in diabetes: A methodological perspective
Jongen, C., & Biessels, G. J. (2008) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2007.11.085 · Cited by 50
Rehabilitation Services Use and Patient-Reported Outcomes Among Older Adults in the United States
Gell, N., Mroz, T. M., & Patel, K. V. (2017) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2017.02.027 · Cited by 51
Asimakopoulou, K. G., Hampson, S. E., & Morrish, N. J. (2002) · Diabetic Medicine · doi:10.1046/j.1464-5491.2002.00680.x · Cited by 50
Molecular and biochemical trajectories from diabetes to Alzheimer’s disease: A critical appraisal
Sandhir, R., & Gupta, S. N. (2015) · World Journal of Diabetes · doi:10.4239/wjd.v6.i12.1223 · Cited by 49
Hormones and Cognition: Current Concepts and Issues in Neuropsychology
Erlanger, D. M., Kutner, K. C., & Jacobs, A. R. (1999) · Neuropsychology Review · doi:10.1023/a:1021634622577 · Cited by 49
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Metadata
- Authors
- Strachan, M. W. J., Deary, I. J., Ewing, F. M. E., & Frier, B. M.
- Affiliations
- University of Edinburgh (GB)
- Edinburgh Royal Infirmary (GB)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 1997-03-01
- Volume
- 20
- Issue
- 3
- Pages
- 438-445
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W1967789041
- Cited by
- 529
- References
- 0
- Citations by year
- 2025: 6 · 2024: 7 · 2023: 7 · 2022: 20 · 2021: 7 · 2020: 12 · 2019: 14 · 2018: 19 · 2017: 19 · 2016: 21 · 2015: 15 · 2014: 25 · 2013: 17 · 2012: 24
- FWCI
- 7.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- type 2 diabetes, cognitive impairment, verbal memory, psychomotor performance, frontal lobe function, diabetes complications, metabolic abnormalities, effect size
- MeSH terms
- Cognition Disorders, Diabetes Mellitus, Type 2, Risk Factors
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