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Cognitive problems
associated with Diabetes duration and
severity
Newswise — Individuals with mild cognitive
impairment appear more likely to have
earlier onset, longer duration and greater
severity of diabetes, according to a report
in the August issue of Archives of
Neurology, one of the JAMA/Archives
journals.
Mild cognitive impairment is a transitional
stage between normal aging and dementia,
according to background information in the
article.
Previous studies have found an association
between mild cognitive impairment and
diabetes.
Poor blood glucose control over time may
lead to neuron loss, and diabetes is
associated with cardiovascular disease risk
and stroke, which also may increase the risk
of cognitive impairment.
Rosebud O. Roberts, M.B.Ch.B., M.S., and
colleagues at Mayo Clinic, Rochester, Minn.,
studied individuals from Olmsted County,
Minnesota, who were age 70 to 89 on Oct. 1,
2004.
Participants received a neurological
examination, neuropsychological evaluation
and tests of blood glucose levels, and
completed an interview with questions about
diabetes history, treatment and
complications.
medical
records linkage system was used to confirm
diabetes history.
Rates of diabetes were similar among 329
individuals with mild cognitive impairment
(20.1 percent) and 1,640 participants
without mild cognitive impairment (17.7
percent). However, mild cognitive impairment
was associated with developing diabetes
before age 65, having diabetes for 10 years
or longer, being treated with insulin and
having diabetes complications.
“Severe diabetes mellitus is more likely to
be associated with chronic hyperglycemia
[high blood glucose], which, in turn,
increases the likelihood of cerebral
microvascular disease and may contribute to
neuronal damage, brain atrophy and cognitive
impairment,” the authors write.
That individuals with the eye disease
diabetic retinopathy were twice as likely to
have mild cognitive impairment supports the
theory that diabetes-related damage to blood
vessels in the brain may contribute to the
development of cognitive problems.
“Our findings suggest that diabetes mellitus
duration and severity, as measured by type
of treatment and the presence of diabetes
mellitus complications, may be important in
the pathogenesis of cognitive impairment in
subjects with diabetes mellitus,” they
conclude.
“In contrast, late onset of diabetes
mellitus, short duration of diabetes
mellitus or well-controlled diabetes
mellitus may have a lesser effect.”
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