Diabetes is associated with increased rate of cognitive decline in questionably demented elderly.
BACKGROUND
This study examines whether the association of diabetes with the rate of cognitive decline varies according to dementia severity.


METHODS
Longitudinal study on subjects residing in nursing homes and assisted living (n = 342). The Mini Mental State Examination (MMSE) was used to measure the rate of cognitive decline in diabetic and nondiabetic subjects who were nondemented (Clinical Dementia Rating, CDR = 0; n = 125), questionably demented (CDR = 0.5; n = 58) or frankly demented (CDR > or =1; n = 89) at baseline. Diagnosis of diabetes was ascertained by review of medical records and history.


RESULTS
Diabetes was associated with an increased rate of decline in the MMSE score of questionably demented subjects (p < 0.0001). In frankly demented subjects, diabetes tended to be associated with less cognitive decline (p = 0.04). Diabetes was not associated with the rate of MMSE decline in nondemented subjects (p = 0.89).


CONCLUSIONS
In individuals with questionable dementia (CDR = 0.5), diabetes is associated with a faster rate of cognitive decline as measured by the MMSE, but not in nondemented (CDR = 0) or frankly demented (CDR > or =1) individuals.
Ravona-Springer
Ramit
R
Memory Clinic, Sheba Medical Center, Ramat Gan, Israel. ramit.ravona@sheba.health.gov.il
Luo
Xiaodong
X
Schmeidler
James
J
Wysocki
Michael
M
Lesser
Gerson
G
Rapp
Michael
M
Dahlman
Karen
K
Grossman
Hillel
H
Haroutunian
Vahram
V
Schnaider Beeri
Michal
M
D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000150:complications / Q000523:psychology*; D015331:Cohort Studies; D003704:Dementia / Q000150:complications / Q000523:psychology*; D048909:Diabetes Complications / Q000523:psychology*; D003920:Diabetes Mellitus / Q000523:psychology*; D018450:Disease Progression; D004493:Education; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors