Changes in Cognitive Abilities Over a 4-Year Period Are Unfavorably Affected in Elderly Diabetic Subjects
Abstract
OBJECTIVE— To compare 4-year changes in cognitive performance among elderly subjects according to category of fasting blood glucose (FBG)using American Diabetes Association criteria. RESEARCH DESIGN AND METHODS— Subjects without any detectable cognitive dysfunction were selected from the Epidemiology of Vascular Aging(EVA) Study, a cohort of community-dwelling people aged 59-71 years at baseline. They were classified into glucose categories (normal, impaired fasting glucose [IFG], or diabetic) based on FBG values or known diabetes. Their cognitive abilities were assessed by a global test (Mini Mental Status Examination [MMSE]) and eight domain-specific tests, and they were reassessed 4 years later. Serious cognitive worsening was defined as a score evolution into the worst 15% of the sample's distribution of score differences (4-year score minus baseline score) for each test. RESULTS— At baseline, age-, sex-, and education-adjusted scores for all cognitive tests except one were similar across glucose categories. After 4 years, diabetic subjects had a lower performance on all tests except the MMSE, with differences reaching statistical significance on four tests. Adjusted odds ratios for serious worsening over 4 years in diabetic subjects, with reference to normal subjects, were >2 for four tests (P < 0.05) and bordering this value for two others(P < 0.09). Further adjustment for blood pressure or potential cognition-affecting substances (alcohol, tobacco, and medications) did not modify these results. CONCLUSIONS— Despite similar high initial cognitive function,diabetic subjects tended to have an unfavorable evolution of cognitive performance over 4 years compared with subjects who had normal glucose or IFG.
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Six studies reported time-related changes as a continuous variable using either the MMSE or 3MS score in individuals with and without a history of diabetes.
“Table 2 lists the six studies that reported time-related changes as a continuous variable using either the MMSE or 3MS score in individuals with and without a history of diabetes [49, 51, 52, 54, 65, 69].”
From Cognitive decline and dementia in diabetes—systematic overview of prospective observational studies (2005) · cites this paper as [51]
Two included studies reported that participants with impaired fasting glucose or impaired glucose tolerance experience more cognitive decline than participants without.
“Moreover, two of the studies included in this review reported that participants with impaired fasting glucose or impaired glucose tolerance experience more cognitive decline than participants without, further supporting a link between cognitive decline and hyperglycaemia [51, 69, 70].”
From Cognitive decline and dementia in diabetes—systematic overview of prospective observational studies (2005) · cites this paper as [51]
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“A longitudinal study of diabetic patients over a span of 4 years reported a decline in cognitive performance, suggesting a relationship between diabetes and cognition [84].”
- Authors
- Fontbonne, A., Berr, C., Ducimetière, P., & Alpérovitch, A.
- Affiliations
- Inserm (FR)
- From the National Institute for Health and Medical Research (INSERM),Unit 258 (A.F., P.D.), Villejuif, and Unit 360 (C.B., A.A.), Paris,France.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2001-02-01
- Volume
- 24
- Issue
- 2
- Pages
- 366-370
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2059804586
- Cited by
- 297
- References
- 25
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 2 · 2022: 4 · 2021: 8 · 2020: 9 · 2019: 14 · 2018: 13 · 2017: 12 · 2016: 11 · 2015: 13 · 2014: 16 · 2013: 8 · 2012: 17
- FWCI
- 7.95
- 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 › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- cognitive decline, diabetes mellitus, older adults, impaired fasting glucose, fasting blood glucose, longitudinal cognitive change, Mini-Mental State Examination, vascular aging
- MeSH terms
- Aged, Aging, Attention, Blood Glucose, Blood Pressure, Cognition Disorders, Diabetes Mellitus, Educational Status, Female, Humans, Male, Memory, Mental Status Schedule, Middle Aged, Psychomotor Performance, Sex Characteristics, Cohort Studies, Odds Ratio, Diabetes Complications
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