Executive dysfunction in homebound older people with diabetes mellitus.
OBJECTIVE
To describe patterns of cognitive deficits and activities of daily living (ADLs) in older people with diabetes mellitus.


METHODS
Cross-sectional, population-based study.


METHODS
Three homecare agency areas in Boston, Massachusetts.


METHODS
Two hundred ninety-one homebound people aged 60 and older; 40% with diabetes mellitus.


METHODS
Demographic data; evidence of diabetes mellitus and other diseases; Mini-Mental State Examination and tests of memory and executive function; ADLs.


RESULTS
Executive and visuospatial functions were more impaired in individuals with diabetes mellitus than in those without, as assessed using Block Design (mean score+/-standard deviation 17.1+/-8.6 vs 20.5+/-9.6, P=.003) and Trails B (median seconds to accomplish the task: 255 vs 201, P=.03). For memory, word retention score was lower in those with diabetes mellitus than without (39.1+/-28.9 vs 48.0+/-29.7, P=.01), but the other memory tests did not show a difference between these two subgroups. More individuals with diabetes mellitus suffered from depressive symptoms than those without (55% vs 42%, P=.03). The ADL scores of those with diabetes mellitus were higher than those without.


CONCLUSIONS
The pattern of cognitive deficits in people with diabetes mellitus suggests frontal-subcortical dysfunction, as seen in microvascular disease of the brain. The impairment in ADLs may be associated with this executive dysfunction, which cerebral microvascular disease in diabetes mellitus may cause.
Friedman School of Nutrition Science and Policy, Department of Psychiatry, Clinical Research Center, Tufts University, Boston, Massachusetts 02111, USA. wqiu@tufts-nemc.org
Wei Qiao
WQ
Qiu
Lori Lyn
LL
Price
Patricia
P
Hibberd
Jennifer
J
Buell
Lauren
L
Collins
Drew
D
Leins
David Mkaya
DM
Mwamburi
Irwin
I
Rosenberg
Lauren
L
Smaldone
Tammy M
TM
Scott
Richard D
RD
Siegel
Paul
P
Summergrad
Xiaoyan
X
Sun
Carey
C
Wagner
Lixia
L
Wang
Jacqueline
J
Yee
Katherine L
KL
Tucker
Marshal
M
Folstein
D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000523:psychology*; D005260:Female; D018577:Homebound Persons; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors