title: Cognitive dysfunction in patients with type 2 diabetes.
abstract: People with diabetes mellitus are at increased risk of cognitive dysfunction and dementia. This review explores the nature and severity of cognitive changes in patients with type 2 diabetes. Possible risk factors such as hypo- and hyperglycemia, vascular risk factors, micro- and macrovascular complications, depression and genetic factors will be examined, as well as findings from brain imaging and autopsy studies. We will show that type 2 diabetes is associated with modest cognitive decrements in non-demented patients that evolve only slowly over time, but also with an increased risk of more severe cognitive deficits and dementia. There is a dissociation between these two 'types' of cognitive dysfunction with regard to affected age groups and course of development. Therefore, we hypothesize that the mild and severe cognitive deficits observed in patients with type 2 diabetes reflect separate processes, possibly with different risk factors and aetiologies.
authors.affiliation: Department of Neurology, Rudolf Magnus Institute of Neurosciences, University Medical Center Utrecht, the Netherlands.
authors.forename: Yael D
authors.initials: YD
authors.lastname: Reijmer
authors.forename: Esther
authors.initials: E
authors.lastname: van den Berg
authors.forename: Carla
authors.initials: C
authors.lastname: Ruis
authors.forename: L Jaap
authors.initials: LJ
authors.lastname: Kappelle
authors.forename: Geert Jan
authors.initials: GJ
authors.lastname: Biessels
mesh_terms: D001921:Brain / Q000503:physiopathology; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology*; D003704:Dementia / Q000209:etiology; D003863:Depression / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications; D007003:Hypoglycemia / Q000150:complications; D008019:Life Style; D008297:Male; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors