Cognitive performance declines in older adults with type 1 diabetes: results from 32 years of follow-up in the DCCT and EDIC Study.
Journal
The lancet. Diabetes & endocrinology
ISSN: 2213-8595
Titre abrégé: Lancet Diabetes Endocrinol
Pays: England
ID NLM: 101618821
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
26
01
2021
revised:
23
03
2021
accepted:
23
03
2021
pubmed:
31
5
2021
medline:
18
8
2021
entrez:
30
5
2021
Statut:
ppublish
Résumé
With improved treatment, individuals with type 1 diabetes are living longer but there is limited information on the effects of type 1 diabetes on cognitive ability as they become older adults. We followed up individuals with type 1 diabetes to identify independent risk factors for cognitive decline as people age. 1051 participants with type 1 diabetes enrolled in the Diabetes Control and Complications Trial (DCCT) and its follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study. Participants completed cognitive assessments at baseline (median age 27 years) and 2, 5, 18, and 32 years later (median age 59). HbA Over 32 years of follow-up, we found substantive declines in memory and psychomotor and mental efficiency. Between 18 and 32 years of follow-up, the decline in psychomotor and mental efficiency was five times larger than the change from baseline to year 18. Independent of the other risk factors and comorbidities, exposure to higher HbA Cognitive function declines with ageing in type 1 diabetes. The association of glycaemia and blood pressure levels with cognitive decline suggests that better management might preserve cognitive function. United States National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Disease.
Sections du résumé
BACKGROUND
With improved treatment, individuals with type 1 diabetes are living longer but there is limited information on the effects of type 1 diabetes on cognitive ability as they become older adults. We followed up individuals with type 1 diabetes to identify independent risk factors for cognitive decline as people age.
METHODS
1051 participants with type 1 diabetes enrolled in the Diabetes Control and Complications Trial (DCCT) and its follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study. Participants completed cognitive assessments at baseline (median age 27 years) and 2, 5, 18, and 32 years later (median age 59). HbA
FINDINGS
Over 32 years of follow-up, we found substantive declines in memory and psychomotor and mental efficiency. Between 18 and 32 years of follow-up, the decline in psychomotor and mental efficiency was five times larger than the change from baseline to year 18. Independent of the other risk factors and comorbidities, exposure to higher HbA
INTERPRETATION
Cognitive function declines with ageing in type 1 diabetes. The association of glycaemia and blood pressure levels with cognitive decline suggests that better management might preserve cognitive function.
FUNDING
United States National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Disease.
Identifiants
pubmed: 34051936
pii: S2213-8587(21)00086-3
doi: 10.1016/S2213-8587(21)00086-3
pmc: PMC8583716
mid: NIHMS1711529
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT00360893', 'NCT00360815']
Types de publication
Clinical Trial
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
436-445Subventions
Organisme : NIDDK NIH HHS
ID : DP3 DK114812
Pays : United States
Organisme : NIA NIH HHS
ID : K24 AG045334
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK094157
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK094176
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2021 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of interests JAL discloses being funded by K24AG045334; consulting for vTv therapeutics; receiving royalties from Springer; and receiving a stipend from Wolters Kluwer. NC discloses personal fees and non-financial support from Eli Lilly, outside the submitted work. All other authors declare no competing interests.
Références
N Engl J Med. 1993 Sep 30;329(14):977-86
pubmed: 8366922
Diabetes Care. 2016 Apr;39(4):603-10
pubmed: 26681721
Diabetologia. 2011 Feb;54(2):245-55
pubmed: 20803190
Diabetes Care. 2019 Mar;42(3):443-449
pubmed: 30573652
Rev Neurosci. 2019 Dec 18;31(1):1-57
pubmed: 31194693
Diabetes Care. 2015 Sep;38(9):1768-76
pubmed: 26153270
J Clin Endocrinol Metab. 2019 Jun 1;104(6):2239-2249
pubmed: 30657922
Diabetes. 2020 Jul;69(7):1528-1539
pubmed: 32295804
J Am Geriatr Soc. 2005 Apr;53(4):695-9
pubmed: 15817019
J Gerontol A Biol Sci Med Sci. 2021 Sep 13;76(10):1829-1838
pubmed: 33313639
Arch Neurol. 2012 Sep;69(9):1170-5
pubmed: 22710333
Lancet Neurol. 2008 Feb;7(2):184-90
pubmed: 18207116
BMJ Open Diabetes Res Care. 2020 Jun;8(1):
pubmed: 32546548
Diabetes Care. 2016 Aug;39(8):1378-83
pubmed: 27411699
J Diabetes Complications. 2016 Nov - Dec;30(8):1513-1518
pubmed: 27601058
Diabetes Care. 2018 Nov;41(11):2339-2345
pubmed: 30181165
Diabetes Care. 2013 Jun;36(6):1554-61
pubmed: 23275366
Diabetes Care. 1999 Jan;22(1):99-111
pubmed: 10333910
Neurology. 2018 Jan 16;90(3):126-135
pubmed: 29282327
Diabetes Care. 2020 Mar;43(3):541-548
pubmed: 31882410
J Am Geriatr Soc. 2011 Mar;59(3):563-5
pubmed: 21391954
Diabetologia. 2003 Jul;46(7):940-8
pubmed: 12819900
Psychol Bull. 2019 Mar;145(3):273-301
pubmed: 30676035
Neuropsychol Rehabil. 2017 Jun;27(4):507-521
pubmed: 26605669
Neurology. 2011 Sep 27;77(13):1272-5
pubmed: 21917776
J Diabetes. 2018 Nov;10(11):835-846
pubmed: 29665283
Ann Intern Med. 1996 Feb 15;124(4):379-88
pubmed: 8554246
Lancet Diabetes Endocrinol. 2014 Mar;2(3):228-35
pubmed: 24622753
N Engl J Med. 2007 May 3;356(18):1842-52
pubmed: 17476010
Arch Gen Psychiatry. 2009 Aug;66(8):878-87
pubmed: 19652127
J Diabetes Complications. 2019 Jan;33(1):91-97
pubmed: 29728302
Neurobiol Dis. 2020 Feb;134:104608
pubmed: 31494283
Diabetes Care. 2020 Oct;43(10):2478-2484
pubmed: 32788280