title: Association of diabetes with amnestic and nonamnestic mild cognitive impairment.
abstract: BACKGROUND
  Type 2 diabetes may increase the risk of amnestic mild cognitive impairment (aMCI) through Alzheimer's disease (AD)-related and vascular pathology and may also increase the risk of nonamnestic MCI (naMCI) through vascular disease mechanisms. We examined the association of type 2 diabetes with mild cognitive impairment (MCI) and MCI subtype (aMCI and naMCI) overall and by sex.
  
  
  METHODS
  Participants were Olmsted County, Minnesota residents (70 years and older) enrolled in a prospective, population-based study. At baseline and every 15 months thereafter, participants were evaluated using the Clinical Dementia Rating scale, a neurological evaluation, and neuropsychological testing for a diagnosis of normal cognition, MCI, and dementia by a consensus panel. Type 2 diabetes was ascertained from the medical records of participants at baseline.
  
  
  RESULTS
  Over a median 4.0 years of follow-up, 348 of 1450 subjects developed MCI. Type 2 diabetes was associated (hazard ratio [95% confidence interval]) with MCI (1.39 [1.08-1.79]), aMCI (1.58 [1.17-2.15]; multiple domain: 1.58 [1.01-2.47]; single domain: 1.49 [1.09-2.05]), and the hazard ratio for naMCI was elevated (1.37 [0.84-2.24]). Diabetes was strongly associated with multiple-domain aMCI in men (2.42 [1.31-4.48]) and an elevated risk of multiple domain naMCI in men (2.11 [0.70-6.33]), and with single domain naMCI in women (2.32 [1.04-5.20]).
  
  
  CONCLUSIONS
  Diabetes was associated with an increased risk of MCI in elderly persons. The association of diabetes with MCI may vary with subtype, number of domains, and sex. Prevention and control of diabetes may reduce the risk of MCI and Alzheimer's disease.
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; Department of Neurology, Mayo Clinic, Rochester, MN, USA. Electronic address: roberts.rosebud@mayo.edu.
authors.forename: Rosebud O
authors.initials: RO
authors.lastname: Roberts
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, MN, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Knopman
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; Department of Psychiatry and Psychology and Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA.
authors.forename: Yonas E
authors.initials: YE
authors.lastname: Geda
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN USA.
authors.forename: Ruth H
authors.initials: RH
authors.lastname: Cha
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN USA.
authors.forename: V Shane
authors.initials: VS
authors.lastname: Pankratz
authors.affiliation: Rollins School of Public Health, Department of Epidemiology, Emory University, Atlanta, GA, USA.
authors.forename: Luke
authors.initials: L
authors.lastname: Baertlein
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Bradley F
authors.initials: BF
authors.lastname: Boeve
authors.affiliation: Division of Primary Care Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Eric G
authors.initials: EG
authors.lastname: Tangalos
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Ivnik
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Mielke
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; Department of Neurology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Petersen
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000647:Amnesia / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D060825:Cognitive Dysfunction / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D015995:Prevalence; D012720:Severity of Illness Index; D012737:Sex Factors
keywords: Cohort studies; Diabetic neuropathy; Diabetic retinopathy; Incidence; Mild cognitive impairment; Population-based studies; Risk factors; Sex differences; Type 2 diabetes
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