Type 2 Diabetes Mellitus and Cognitive Decline in Two Large Cohorts of Community-Dwelling Older Adults

  1. Olivia I. Okereke MD, SM,
  2. Jae H. Kang ScD,
  3. Nancy R. Cook ScD,
  4. J. Michael Gaziano MD,
  5. JoAnn E. Manson MD, DrPH,
  6. Julie E. Buring ScD,
  7. Francine Grodstein ScD

Article first published online: 1 APR 2008

DOI: 10.1111/j.1532-5415.2008.01686.x

Issue

Journal of the American Geriatrics Society

Journal of the American Geriatrics Society

Volume 56, Issue 6, pages 1028–1036, June 2008

Additional Information

How to Cite

Okereke, O. I., Kang, J. H., Cook, N. R., Gaziano, J. M., Manson, J. E., Buring, J. E. and Grodstein, F. (2008), Type 2 Diabetes Mellitus and Cognitive Decline in Two Large Cohorts of Community-Dwelling Older Adults. Journal of the American Geriatrics Society, 56: 1028–1036. doi: 10.1111/j.1532-5415.2008.01686.x

Author Information

  1. From the *Division of Aging†Channing Laboratory‡Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts§Department of Epidemiology, Harvard Medical School, Boston, Massachusetts∥Veterans Affairs Boston Healthcare System, Jamaica Plain, Massachusetts.

*Address correspondence to Dr. Olivia Okereke, Channing Laboratory 3rd floor, 181 Longwood Avenue, Boston, MA 02115. E-mail: ookereke@partners.org

  1. Presented at the poster session of the Alzheimer's Association International Conference on Prevention of Dementia, Washington, DC, June 2007.

Publication History

  1. Issue published online: 1 APR 2008
  2. Article first published online: 1 APR 2008

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Keywords:

  • diabetes mellitus;
  • cognitive decline;
  • dementia;
  • aging;
  • gender

OBJECTIVES: To relate diabetes mellitus (DM) status and duration to late-life cognitive impairment and decline in men and women.

DESIGN: Prospective cohort.

SETTING: Community.

PARTICIPANTS: Five thousand nine hundred seven men in the Physicians' Health Study II and 6,326 women in the Women's Health Study (mean age 74.1 and 71.9, respectively, at baseline cognitive assessment); 553 men and 405 women had DM.

MEASUREMENTS: Primary outcomes were general cognition (the Telephone Interview for Cognitive Status (TICS) and a global score averaging five tests) and verbal memory. All participants had second assessments approximately 2 years later; women had third assessments an average of 4 years later.

RESULTS: In adjusted linear regression models, participants with DM had significantly lower baseline scores for all outcomes, and longer duration of DM was associated with lower scores (P-trends <.001). Men with DM had significantly greater 2-year cognitive decline than men without DM, and longer duration of DM was associated with worse decline (P-trends ≤.01). In repeated-measures analyses of response profiles, women with DM had significantly greater 4-year cognitive decline in all outcomes than women without DM. In women, as in men, there was generally greater cognitive decline with longer duration of DM (e.g., the adjusted mean difference in decline on the TICS associated with duration of ≥5 years was −0.74 (95% confidence interval=−1.05 to −0.43) points (P-trend <.001). There were no significant sex–DM interactions.

CONCLUSION: Type 2 DM and longer duration of DM are similarly related to cognitive impairment and decline in men and women.

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