title: Factors associated with cognitive decline in elderly diabetics.
abstract: OBJECTIVE
  Although recent evidence has indicated that type 2 diabetes mellitus (T2DM) in the elderly is a risk factor for cognitive dysfunction or dementia, few studies have prospectively observed this potential cognitive decline. In the current study, we performed cognitive assessments at baseline and after 3 years in the same patient group in an attempt to reveal the contributions of diabetes-related factors to the increased decline in cognitive function in elderly patients with T2DM.
  
  
  METHODS
  We recruited 55 consecutive T2DM patients with a Mini-Mental State Examination (MMSE) score ≥24 from the Diabetic Center at the Chubu Rosai Hospital. These patients ranged in age from 65 to 85 years. Cognitive and clinical assessments, including brain MRI, were performed at baseline and at the 3-year follow-up.
  
  
  RESULTS
  The higher plasma insulin and HbA(1c) levels observed at baseline were significantly associated with a worse cognitive performance at baseline and a more neurocognitive decline at the follow-up visit.
  
  
  CONCLUSIONS
  The current prospective study suggests that higher insulin and glycohemoglobin levels may be associated with diabetes-related cognitive dysfunction.
authors.affiliation: Department of Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Umegaki
authors.forename: Takahiko
authors.initials: T
authors.lastname: Kawamura
authors.forename: Naoko
authors.initials: N
authors.lastname: Kawano
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Umemura
authors.forename: Akio
authors.initials: A
authors.lastname: Kanai
authors.forename: Takahisa
authors.initials: T
authors.lastname: Sano