Cognitive decline following incident and preexisting diabetes mellitus in a population sample

Kumar Rajan, Zoe Arvanitakis, Elizabeth B. Lynch, Elizabeth A. McAninch, Robert S. Wilson, Jennifer Weuve, Lisa L. Barnes, Antonio C. Bianco, Denis A. Evans

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective: To examine if incident and preexisting diabetes mellitus (DM) were associated with cognitive decline among African Americans (AAs) and European Americans (EAs). Methods: Based on a prospective study of 7,740 older adults (mean age 72.3 years, 64% AA, 63% female), DM was ascertained by hypoglycemic medication use and Medicare claims during physician or hospital visits, and cognition by performance on a brief battery for executive functioning, episodic memory, and Mini-Mental State Examination (MMSE). Decline in composite and individual tests among those with incident DM, with preexisting DM, and without DM was studied using a linear mixed effects model with and without change point. Results: At baseline, 737 (15%) AAs and 269 (10%) EAs had preexisting DM. Another 721 (17%) AAs and 289 (12%) EAs had incident DM in old age. Following incident DM, cognitive decline increased by 36% among AAs and by 40% among EAs compared to those without DM. No significant difference was observed between AAs and EAs (p 0.64). However, cognitive decline increased by 17% among AAs with preexisting DM compared to those without DM, but no increased decline was observed among EAs with preexisting DM. In secondary analyses, faster decline in executive functioning and episodic memory was observed following incident DM. Conclusions: In old age, faster cognitive decline was present among AAs and EAs following incident DM, compared to cognitive decline prior to DM, and among those without DM. This underscores the need for stronger prevention and control of DM in old age.

Original languageEnglish (US)
Pages (from-to)1681-1687
Number of pages7
JournalNeurology
Volume87
Issue number16
DOIs
StatePublished - Oct 18 2016
Externally publishedYes

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Diabetes Mellitus
Population
African Americans
Cognitive Dysfunction
Episodic Memory
Medicare
Hypoglycemic Agents
Cognition
Prospective Studies

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Rajan, K., Arvanitakis, Z., Lynch, E. B., McAninch, E. A., Wilson, R. S., Weuve, J., ... Evans, D. A. (2016). Cognitive decline following incident and preexisting diabetes mellitus in a population sample. Neurology, 87(16), 1681-1687. https://doi.org/10.1212/WNL.0000000000003226

Cognitive decline following incident and preexisting diabetes mellitus in a population sample. / Rajan, Kumar; Arvanitakis, Zoe; Lynch, Elizabeth B.; McAninch, Elizabeth A.; Wilson, Robert S.; Weuve, Jennifer; Barnes, Lisa L.; Bianco, Antonio C.; Evans, Denis A.

In: Neurology, Vol. 87, No. 16, 18.10.2016, p. 1681-1687.

Research output: Contribution to journalArticle

Rajan, K, Arvanitakis, Z, Lynch, EB, McAninch, EA, Wilson, RS, Weuve, J, Barnes, LL, Bianco, AC & Evans, DA 2016, 'Cognitive decline following incident and preexisting diabetes mellitus in a population sample', Neurology, vol. 87, no. 16, pp. 1681-1687. https://doi.org/10.1212/WNL.0000000000003226
Rajan, Kumar ; Arvanitakis, Zoe ; Lynch, Elizabeth B. ; McAninch, Elizabeth A. ; Wilson, Robert S. ; Weuve, Jennifer ; Barnes, Lisa L. ; Bianco, Antonio C. ; Evans, Denis A. / Cognitive decline following incident and preexisting diabetes mellitus in a population sample. In: Neurology. 2016 ; Vol. 87, No. 16. pp. 1681-1687.
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