Relation of diabetes to mild cognitive impairment.
BACKGROUND
Type 2 diabetes mellitus is an important risk factor for Alzheimer disease and is more prevalent in elderly minority persons compared with non-Hispanic white persons.


OBJECTIVE
To determine whether diabetes is related to a higher risk of mild cognitive impairment (MCI), a transitional stage between normal cognition and Alzheimer disease, in a multiethnic cohort with a high prevalence of diabetes.


METHODS
Longitudinal cohort study.


METHODS
Northern Manhattan in New York, NY.


METHODS
We studied persons without prevalent MCI or dementia at baseline and with at least 1 follow-up interval. Of 1772 participants with a complete neuropsychological evaluation, 339 (19.1%) were excluded because of prevalent dementia, 304 were excluded because of prevalent MCI (17.2%), and 211 were excluded because of loss to follow-up (11.9%), resulting in a final sample of 918 participants for longitudinal analyses.


METHODS
We related diabetes defined by self-report to incident all-cause MCI, amnestic MCI, and nonamnestic MCI. We conducted multivariate analyses with proportional hazards regression adjusting for age, sex, years of education, ethnic group, apolipoprotein E (APOE) epsilon4 allele, hypertension, low-density lipoprotein level, current smoking, heart disease, and stroke.


RESULTS
A total of 334 persons had incident MCI, 160 (47.9%) had amnestic MCI, and 174 (52.1%) had nonamnestic MCI. Diabetes was related to a significantly higher risk of all-cause MCI and amnestic MCI after adjustment for all covariates. Diabetes was also related to a higher risk of nonamnestic MCI, but this association was appreciably attenuated after adjustment for socioeconomic variables and vascular risk factors. The risk of MCI attributable to diabetes was 8.8% for the whole sample and was higher for African American persons (8.4%) and Hispanic persons (11.0%) compared with non-Hispanic white persons (4.6%), reflecting the higher prevalence of diabetes in minority populations in the United States.


CONCLUSIONS
Diabetes is related to a higher risk of amnestic MCI in a population with a high prevalence of this disorder.
Luchsinger
José A
JA
Department of Medicine, Taub Institute for Research of Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY 10032, USA. jal94@columbia.edu
Reitz
Christiane
C
Patel
Bindu
B
Tang
Ming-Xin
MX
Manly
Jennifer J
JJ
Mayeux
Richard
R
D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001057:Apolipoproteins E / Q000235:genetics; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000208:ethnology / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data
D001057:Apolipoproteins E