Cognitive performance in midlife type 2 diabetes: results from the ENBIND study.
Adult
Aged
Cognition
/ physiology
Cognitive Dysfunction
/ epidemiology
Cross-Sectional Studies
Diabetes Mellitus, Type 2
/ complications
Educational Status
Female
Follow-Up Studies
Humans
Incidence
Ireland
/ epidemiology
Male
Memory
/ physiology
Mental Status and Dementia Tests
Middle Aged
Neuropsychological Tests
Risk Factors
Journal
Diabetic medicine : a journal of the British Diabetic Association
ISSN: 1464-5491
Titre abrégé: Diabet Med
Pays: England
ID NLM: 8500858
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
revised:
14
09
2020
received:
05
06
2020
accepted:
23
09
2020
pubmed:
1
10
2020
medline:
24
3
2022
entrez:
30
9
2020
Statut:
ppublish
Résumé
To establish the impact of uncomplicated type 2 diabetes on cognitive and neuropsychological performance in midlife. We performed a cross-sectional study of middle-aged adults with uncomplicated type 2 diabetes and a cohort of healthy control participants. General cognition was assessed using the Montreal Cognitive Assessment test and neuropsychological assessment was undertaken using a detailed neuropsychological assessment battery. A total of 152 participants (102 with type 2 diabetes and 50 controls) were recruited (mean age 52 ± 8 years, 51% women). Participants with midlife type 2 diabetes were more than twice as likely to make an error on the Montreal Cognitive Assessment test [incidence rate ratio 2.44 (95% CI 1.54 to 3.87); P < 0.001]. Further, type 2 diabetes was also associated with significantly lower memory composite score [β: -0.20 (95% CI -0.39 to -0.01); P = 0.04] and paired associates learning score [β: = -1.97 (95% CI -3.51, -0.43); P = 0.01] on the neuropsychological assessment battery following adjustment for age, sex, BMI, educational attainment and hypercholesterolaemia. Even in midlife, type 2 diabetes was associated with small but statistically significant cognitive decrements. These statistically significant decrements, whilst not clinically significant in terms of objective cognitive impairment, may have important implications in selecting out individuals most at risk of later cognitive decline for potential preventative interventions in midlife.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14412Informations de copyright
© 2020 Diabetes UK.
Références
Gudala K, Bansal D, Schifano F, Bhansali A. Diabetes mellitus and risk of dementia: A meta-analysis of prospective observational studies. J Diabetes Investig. 2013;4:640-650.
Ott A, Stolk RP, van Harskamp F, Pols HA, Hofman A, Breteler MM. Diabetes mellitus and the risk of dementia: The Rotterdam Study. Neurology. 1999;53:1937-1942.
Liebson CL, Rocca WA, Hanson VA, et al. The risk of dementia among persons with diabetes mellitus: a population-based cohort study. Ann N Y Acad Sci. 1997;826:422-427.
Gottesman RF, Albert MS, Alonso A, et al. Associations Between Midlife Vascular Risk Factors and 25-Year Incident Dementia in the Atherosclerosis Risk in Communities (AIRC) Cohort. JAMA Neurol. 2017;74:1246-1254.
Knopman DS, Gottesman RF, Sharrett AR, et al. Midlife vascular risk factors and midlife cognitive status in relation to prevalence of mild cognitive impairment and dementia in later life: The Atherosclerosis Risk in Communities Study. Alzheimers Dement. 2018;14:1406-1415.
Van den Berg E, de Craen AJ, Biessels GJ, Gussekloo J, Wstendorp RGJ. The impact of diabetes mellitus on cognitive decline in the oldest old: A prospective population based study. Diabetologia. 2006;49:2015-2023.
Pelimanni E, Jehkonen M. Type 2 diabetes and Cognitive Functions in Middle Age: A Meta-Analysis. J Int Neuropsychol Soc. 2018;21:1-16.
Aberle I, Kliegel M, Zimprich D. Cognitive development in young-old type-2 diabetes patients: A longitudinal analysis from the “Interdisciplinary Longnitudinal Study of Aging”. Curr Psychol. 2008;27:6-15.
Garcia-Casares N, Jorge RE, Garcia-Arnes AL, et al. Cognitive dysfunctions in middle-aged type 2 diabetic patients and neuroimaging correlations: A cross-sectional study. J Alzheimers Dis. 2014;42:1337-1346.
Ryan CM, Geckle MO. Circumscribed cognitive dysfunction in middle-aged adults with type 2 diabetes. Diabetes Care. 2000;23:1486-1493.
Solanki RK, Dubey V, Munshi D. Neurocognitive impairment and comorbid depression in patients of diabetes mellitus. Int J Diabetes Dev Ctries. 2009;29:133-138.
Mehrabian S, Raycheva M, Gateva A, et al. Cognitive Dysfunction profile and Arterial Stiffness in Type 2 diabetes. J Neurol Sci. 2012;322:152-156.
Biessels JG, ter Braak EWM, Erkelens DW, Hijman R. Cognitive Function in Patients with Type 2 diabetes Mellitus. Neurosci Res Comm. 2001;28:11-22.
Kivipelto M, Mangialasche F, Ngandu T. Lifestyle Interventions to Prevent Cognitive Impairment, Dementia and Alzheimer Disease. Nat Rev Neurol. 2018;14:653-666.
Ngandu T, Lehtisalo J, Solomon A, et al. A 2 year multi-domain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): A Randomised Controlled Trial. Lancet. 2015;385:2255-2263.
Dyer AH, Briggs R, Mockler D, Gibney J, Kennelly SP. Non-pharmacological interventions for cognition in patients with Type 2 diabetes Mellitus: A Systematic Review. QJM. 2020;113:155-161.
Kenny RA, Coen RF, Frewen J, Donoghue O, Cronin H, Savva GM. Normative Values of Cognitive and Physical Function in Older Adults: Findings from The Irish Longitudinal Study of Ageing. J Am Geriatr Soc. 2013;61:S279-S290.
Briggs R, Carey D, O’Halloran KRA, Kennelly SP. Validation of the 8-iten Centre for Epidemiological Studies Depression Scale in a Cohort of Community-Dwelling Older People: Data from The Irish Longitudinal Study on Ageing (TILDA). Eur Geriatr Med. 2018;9:121-126.
Meijer JW, Smith AJ, Sonderen EV, Groothoff JW, Eisma WH, Links TP. Symptom Scoring Systems to Diagnose Distal Polyneuropeathy in Diabetes: The Diabetic Neuropathy Symptom Score. Diabet Med. 2002;19:962-965.
Lowe C, Rabbit P. Test/re-test reliability of the CANTAB and ISPOCD neuropsychological batteries: Theoretical and practical issues. Cambridge Neuropsychological Test Automated Battery. International Study of Post-Operative Cognitive Dysfunction. Neuropsychologia. 1998;36:915-932.
Soldan A, Pettigrew C, Moghekar A, Albert M, BIOCARD Research Team. Computerized cognitive tests are associated with biomarkers of Alzheimer’s disease in cognitively normal individuals 10 years prior. J Int Neuropsychol Soc. 2016;22:968-977.
Palta P, Schneider ALC, Biessels J, Touradji P, Hill-Briggs F. Magnitude of cognitive dysfunction in adults with type 2 diabetes: A meta-analysis of six domains and the most frequently reported neuropsychological tests within domains. J Int Neuropsychol Soc. 2014;20:278-291.
Jan Biessels G, Despa F. Cognitive Decline and Dementia in Diabetes Mellitus: Mechanisms and Clinical Implications. Nat Rev Endocrinol. 2018;14:591-604.
Owen AM, Sahakian BJ, Semple J, Polkey CE, Robbins TW. Visuo-spatial short-term recognition memory and learning after temporal lobe excisions, frontal excisions or amygdalo-hippocampectomy in man. Neuropsychologia. 1995;33:1-24.
Ryan CM, Freed MI, Rood JA, Cobitz AR, Waterhouse BR, Strachan MWJ. Improving metabolic control leads to better working memory in adults with type 2 diabetes. Diabetes Care. 2006;29:345-351.
Bernardes G, Ijzerman RG, ten Kulve JS, et al. Cortical and subcortical gray matter structural alterations in normoglycemic obese and type 2 diabetes patients: Relationship with adiposity, glucose and insulin. Metab Brain Dis. 2018;33:1211-1222.
Moran C, Phan TG, Chen J, et al. Brain Atrophy in Type 2 diabetes: Regional distribution and influence on cognition. Diabetes Care. 2013;36:4036-4042.
Dolan C, Glynn R, Griffin S, et al. Brain Complications of Diabetes Mellitus: A Cross-Sectional Study of Awareness Among Individuals with Diabetes and the General Population in Ireland. Diabet Med. 2018;35:871-879.
American Diabetes Association. Older Adults: Standards of Medical Care in diabetes-2019. Diabetes Care. 2019;42:S139-S147.