Journal
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
Volume 63, Issue 6, Pages 1075-1083Publisher
WILEY
DOI: 10.1111/jgs.13441
Keywords
diabetes mellitus; cognition; aging; vascular risk factors
Categories
Funding
- National Institute on Aging [AG026413, AG037212, AG030995, K99AG042483]
- National Institute on Mental Health [T32 MH 19934-17]
- National Institute on Minority Health and Health Disparities [P60 MD000206]
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ObjectivesTo examine the association between diabetes mellitus and cognitive functioning at baseline and cognitive change over time in a large, ethnically diverse sample of older adults. DesignProspective cohort study. SettingWashington Heights-Inwood Columbia Aging Project, a community-based, prospective study of risk factors for dementia in northern Manhattan, New York City. ParticipantsHispanic, non-Hispanic black, and non-Hispanic white men and women aged 65 and older without dementia at baseline (N=1,493). MeasurementsParticipants underwent baseline and follow-up cognitive and health assessments approximately every 18months. Generalized estimating equations were used to examine the longitudinal association between diabetes mellitus and cognition. ResultsDiabetes mellitus was associated with poorer baseline cognitive performance in memory, language, processing speed and executive functioning, and visuospatial abilities. After adjusting for age, education, sex, race and ethnicity, and apolipoprotein-epsilon 4, participants with diabetes mellitus performed significantly worse at baseline than those without in language and visuospatial abilities. There were no differences between those with and without diabetes mellitus in terms of rate of cognitive change over a mean follow-up time of 6years. ConclusionThe rate of cognitive change in elderly persons with and without diabetes mellitus is similar, although cognitive performance is poorer in persons with diabetes mellitus. These findings suggest that cognitive changes may occur early during the diabetes mellitus process and highlight the need for studies to follow participants beginning at least in midlife, before the typical later-life onset of dementia.
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