A 4 year follow-up study of cognitive functioning in patients with type 2 diabetes mellitus.
OBJECTIVE
Type 2 diabetes mellitus is associated with moderate decrements in cognitive functioning, mainly in verbal memory, information-processing speed and executive functions. How this cognitive profile evolves over time is uncertain. The present study aims to provide detailed information on the evolution of cognitive decrements in type 2 diabetes over time.


METHODS
Sixty-eight patients with type 2 diabetes and 38 controls matched for age, sex and estimated IQ performed an elaborate neuropsychological examination in 2002-2004 and again in 2006-2008, including 11 tasks covering five cognitive domains. Vascular and metabolic determinants were recorded. Data were analysed with repeated measures analysis of variance, including main effects for group, time and the group x time interaction.


RESULTS
Patients with type 2 diabetes showed moderate decrements in information-processing speed (mean difference in z scores [95% CI] -0.37 [-0.69, -0.05]) and attention and executive functions (-0.25 [-0.49, -0.01]) compared with controls at both the baseline and the 4 year follow-up examination. After 4 years both groups showed a decline in abstract reasoning (-0.16 [-0.30, -0.02]) and attention and executive functioning (-0.29 [-0.40, -0.17]), but there was no evidence for accelerated cognitive decline in the patients with type 2 diabetes as compared with controls (all p > 0.05).


CONCLUSIONS
In non-demented patients with type 2 diabetes, cognitive decrements are moderate in size and cognitive decline over 4 years is largely within the range of what can be viewed in normal ageing. Apparently, diabetes-related cognitive changes develop slowly over a prolonged period of time.
van den Berg
E
E
Department of Neurology (G03.228), Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, 3508 GA Utrecht, the Netherlands. e.vandenberg-6@umcutrecht.nl
Reijmer
Y D
YD
de Bresser
J
J
Kessels
R P C
RP
Kappelle
L J
LJ
Biessels
G J
GJ
D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003071:Cognition / Q000502:physiology*; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007360:Intelligence; D008297:Male; D008568:Memory; D008875:Middle Aged; D009426:Netherlands; D010555:Personality Inventory; D011581:Psychological Tests; D012016:Reference Values; D020521:Stroke / Q000453:epidemiology; D014706:Verbal Learning
D006442:Glycated Hemoglobin