Cognition in the Finnish Diabetes Prevention Study

International journal of collaborative research on internal medicine and public health, 2014

Introduction: The increasing prevalence of diabetes over the world has become an important public health problem. Diabetes is considered a non-communicable disease nowadays, with about 173 million diabetic people over the world. Generally, problems for the elderly are impaired activities of daily living (ADL) and cognitive dysfunction. Central nervous system involvement is increasingly recognized as a possible complication of diabetes. Cognitive impairment might be another factor associated with poor diabetes control and also with bad adherence of patients to educational approaches, such as diet orientations. Objective: To assess the cognitive impairment in type 2 diabetes. Methods: A cross sectional study was designed and patients were recruited from Abbasi Shaheed Hospital with a non-probability convenient sampling. Patients having type 2 diabetes over 30 years of age were included and patients with blindness, stroke and psychiatric disorders were excluded. Sample size was done by...

2008

Persons with type 2 diabetes are at increased risk of cognitive dysfunction. Less is known about which cognitive abilities are affected and how undiagnosed diabetes and impaired fasting glucose relate to cognitive performance. The authors explored this question using data from 1,917 nondemented men and women (average age ¼ 76 years) in the population-based Age, Gene/Environment Susceptibility-Reykjavik Study (2002)(2003)(2004)(2005)(2006). Glycemic status groups included diagnosed diabetes (self-reported diabetes or diabetic medication use; n ¼ 163 (8.5%)), undiagnosed diabetes (fasting blood glucose !7.0 mmol/L without diagnosed diabetes; n ¼ 55 (2.9%)), and impaired fasting glucose (fasting blood glucose 5.6-6.9 mmol/L; n ¼ 744 (38.8%)). Composites of memory, processing speed (PS), and executive function were constructed from a neuropsychological battery. Linear regression was used to investigate cross-sectional differences in cognitive performance between glycemic groups, adjusted for demographic and health factors. Persons with diagnosed diabetes had slower PS than normoglycemics (b ¼ À0.12; P < 0.05); diabetes duration of !15 years was associated with significantly poorer PS and executive function. Undiagnosed diabetics had slower PS (b ¼ À0.22; P < 0.01) and poorer memory performance (b ¼ À0.22; P < 0.05). Persons with type 2 diabetes have poorer cognitive performance than normoglycemics, particularly in PS. Those with undiagnosed diabetes have the lowest cognitive performance.

Diabetes/metabolism research and reviews, 2015

Type 2 diabetes is linked with cognitive dysfunction and dementia in epidemiological studies, but these observations are limited by lack of data on the exact timing of diabetes onset. We investigated diabetes, dysglycaemia, and cognition in the Finnish Diabetes Prevention Study (DPS), in which the timing and duration of diabetes is well documented. The DPS comprised middle-aged, overweight participants with impaired glucose tolerance (IGT) but no diabetes at baseline (n = 522), randomized to lifestyle intervention or a control group. After an intervention period (mean duration 4 years) and follow-up (additional 9 years), cognitive assessment with the CERAD test battery and Trail Making Test A (TMT) was executed twice within a two-year interval. Of the 364 (70%) participants with cognitive assessments, 171 (47%) had developed diabetes. Cognitive function did not differ between those who developed diabetes and those who did not. Lower mean 2-h glucose at an oral glucose tolerance test...

Diabetes Care, 2009

OBJECTIVE -Diabetes is associated with cognitive decline and dementia. However, the relationship between the degree of hyperglycemia and cognitive status remains unclear. This was explored using baseline cognitive measures collected in the ongoing Memory in Diabetes (MIND) substudy of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial.

Journal of Basic and Clinical Physiology and Pharmacology, 2020

Mild cognitive impairment (MCI) is a modifiable risk factor in progression of several diseases including dementia and type 2 diabetes. If cognitive impairments are not reversed at an early stage of appearance of symptoms, then the prolonged pathogenesis can lead to dementia and Alzheimer’s disease (AD). Therefore, it is necessary to detect the risk factors and mechanism of prevention of cognitive dysfunction at an early stage of disease. Poor lifestyle, age, hyperglycemia, hypercholesterolemia, and inflammation are some of the major risk factors that contribute to cognitive and memory impairments in diabetic patients. Mild cognitive impairment was seen in those individuals of type 2 diabetes, who are on an unhealthy diet. Physical inactivity, frequent alcohol consumptions, and use of packed food products that provides an excess of cheap calories are found associated with cognitive impairment and depression in diabetic patients. Omega fatty acids (FAs) and polyphenol-rich foods, espe...

International Journal of Basic & Clinical Pharmacology, 2018

Background: To evaluate the impact of type-II diabetes mellitus on cognitive function and to assess the factors associated with impaired function.Methods: This prospective study compared 100 type-II diabetic people attending the diabetic clinic of Tirunelveli Medical College Hospital with another 100 membered control group. The study group was selected randomly between the age group of 45-65 years. A neuro-cognitive assessment was done using Standardized Mini Mental State Examination (SMMSE), which is a simple and reliable screening test. This scale has 12 questions with time limits to assess orientation, memory, calculation, language, attention and construction. Magnitude and severity of cognitive decrement were analysed along with the possible factors affecting it.Results: Mean age of the study population was 54.6±7.24 years. Cognitive impairment was noted among 62 of cases and 48 of the control group, which means a 14% higher prevalence of cognitive impairment among the type 2 di...

Introduction:- Increase in life expectancy and fall in death rate has led to rise in the proportion of the elderly in the community all over the world. The ageing population is facing a double epidemic of dementia including Alzheimer’s disease and diabetes mellitus. The increase in diabetes among elderly is concerning because, in addition to the traditional diabetes complications like acute hyperglycemic and hypoglycemic events and vascular complications, diabetes also affects the central nervous system, a complication referred to as ‘diabetic encephalopathy’, which presents as impaired cognitive functioning and is also associated with an increased risk of dementia. Hence this study was under taken to draw attention to the occurrence of cognitive impairment in type 2 diabetes mellitus, in our community, and thereby pave the way for future initiatives to reduce its incidence. Aim and objectives:- To compare the cognitive functions of elderly non-diabetic subjects with that of elderly type 2 diabetes mellitus subjects using standard neuropsychological tests and to correlate with their blood sugar and lipid levels. Materials and methods:- The study was conducted in 60 participants in the age group of 58-65 years. Of these the case group comprised of 30 individuals with type 2 diabetes mellitus and the control group was formed by age, gender and education matched non-diabetic individuals. Blood samples were collected from all participants. After a brief screening test the participants were asked to take the neuropsychological test battery for evaluating their cognitive status. Comparison of the raw test scores of the cases and controls was done using the student‘t’ test. Results and conclusion:- The diabetes group showed poorer performance in all the cognitive function tests than the non-diabetes group with no correlation between blood glucose and cholesterol levels and the neuropsychological test scores of the patients. Hence, it can be concluded that periodical assessment of cognitive functions in diabetes clinics would be helpful in early identification and management of cases with cognitive impairment, which in turn can reverse the cognitive decline and prevent the development of dementias in these patients.

European Journal of Pharmacology, 2004

Type 2 diabetes and dementia in the elderly are major public health problems. Cross-sectional studies have suggested that these two conditions may be inter-related, but the nature of this association is uncertain. Causation can only be established through studies with a longitudinal design, taking into account the many potential confounding factors in any study of cognition. A literature search has identified 10 studies (nine population-based and one of case-controlled design) that included a definable diabetic population and assessments of cognitive function at baseline and at follow-up. These 10 studies utilised a combination of domain-specific cognitive assessments and a clinical diagnosis of dementia in the assessment of cognitive function. Diabetes was associated with either an accelerated cognitive decline or an increased incidence of dementia in eight of nine of the population-based studies. One study demonstrated a relationship between diabetes and vascular cognitive impairment, but not with other types of dementia. No association between type 2 diabetes and cognitive decline was demonstrated in the case-controlled study. These studies provide compelling evidence to support the view that people with type 2 diabetes are at increased risk of developing cognitive impairment in comparison with the general population. D

Endocrine Abstracts, 2016

Journal of Clinical and Experimental Neuropsychology, 2004

The present review integrates findings of published studies that have evaluated the cognitive function of treated and untreated type 2 diabetic patients and provides a detailed overview of the neuropsychological assessments conducted. Cognitive deficits are observed in older people with glucose intolerance or untreated diabetes but these deficits appear to be attenuated by treatments that improve glycemic control. Cognitive decrements in treated type 2 diabetic patients are most consistently observed on measures of verbal memory (35% of the measures) and processing speed (45% of the measures) while preserved function is observed on measures of visuospatial, attention, semantic and language function. Some studies suggest that deficits in cognitive functions are associated with poorer glycemic control. A number of other factors, such as depression, cardiovascular and cerebrovascular disease, increase these deficits. We conclude that, in diabetic patients who achieve and maintain good glycemic control, type 2 diabetes only has a small impact on cognitive functions before the age of 70 years. However, early onset of type 2 diabetes, poor glycemic control and the presence of micro-and macrovascular disease may interact to produce early cognitive deficits. In older adults (70 years and over), diabetes likely interacts with other dementing processes such as vascular disease and Alzheimer's disease to hasten cognitive decline.