The effect of improved glycemic control on cognitive functions in the elderly patient with diabetes.
BACKGROUND
A number of studies have found that cognitive function is impaired in elderly patients with non-insulin dependent diabetes mellitus (NIDDM) when compared with age-matched non-diabetic controls. In addition, it has been reported that elderly NIDDM patients who have poor glycemic control have a greater impairment in cognition that elderly NIDDM patients with good control. We conducted the following prospective study to determine if improved glycemic control would result in an improvement in cognitive function in elderly patients with NIDDM:


METHODS
Sixteen untreated elderly patients with NIDDM underwent a battery of neuropsychologic tests on two occasions, separated by at least two weeks. They were then started on an oral hypoglycemic agent. After they had been on a stable dose of medication for 6 months the neuropsychologic tests were repeated.


RESULTS
Fasting glucose decreased significantly after treatment (before: 13.8 +/- 1.2 mmol/l; after 8.4 +/- 0.4 mmol/l, p < .01). After 6 months of treatment patients had improvement in their scores on the Grooved Pegboard, Trail Making-Part A, Stroop-Word Naming, Cued Recall and Picture Arrangement tests (all p < .05).


CONCLUSIONS
Improved glycemic control in the elderly patient with NIDDM may have beneficial effects on selective areas of cognition.
Meneilly
G S
GS
Department of Medicine, University of British Columbia, Vancouver.
Cheung
E
E
Tessier
D
D
Yakura
C
C
Tuokko
H
H
D000339:Affect; D000368:Aged; D001288:Attention; D001786:Blood Glucose / Q000032:analysis*; D003071:Cognition; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007858:Learning; D008297:Male; D008609:Mental Status Schedule; D011597:Psychomotor Performance
D001786:Blood Glucose; D007004:Hypoglycemic Agents