Cognitive impairment and limited dietary diversity or physical inactivity are conjoint precursors of incident diabetes more so in elderly women than men.
OBJECTIVE
To establish whether elderly people with impaired cognition are at greater risk for the de-velopment of type 2 diabetes.


METHODS
Prospective population-based cohort study.


METHODS
The El-derly Nutrition and Health Survey in Taiwan (NAHSIT Elderly).


METHODS
One thousand and four hundred ninety-three diabetes-free people >=65 years were followed for incident diabetes in relation to cognitive status for up to 8 years.


METHODS
The association between cognitive impairment and diabetes incidence was analyzed with Cox proportional hazards models with exclusion of people who had diabetes within one year of cognitive function assessments.


RESULTS
Cognitively-impaired women, but not men, had increased diabetes incidence density (DID). Age, gender, ethnicity and personal behavior adjusted hazard ratios (HR) and 95% confidence intervals (CI) for type 2 diabetes with normal cognition as referent were 2.43 (95% CI: 1.27-4.63) for women and 1.55 (95% CI: 0.48-5.07) for men. These gender differences and the HR significances remained with adjustments for age, ethnicity, financial status, dietary quality as a dietary diversity score, physical function, physical activity, fasting glucose, indices of body composition, body mass index, waist circumference, mid-arm muscle circumference, perceived and mental health status. There were extensive significant interactions with the covariates in women.


CONCLUSIONS
Cognitive impairment in later life is associated with greater risk of type 2 diabetes in women and considerable potential risk enhancement.
Division of Preventive Medicine and Health Services Research, Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County 350, Taiwan, ROC. profmlw@nhri.org.tw.
Li-Li
LL
Xiu
Mark L
ML
Wahlqvist
Meei-Shyuan
MS
Lee
Rosalind Chia-Yu
RC
Chen
D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D003072:Cognition Disorders / Q000150:complications*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology; D004032:Diet; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology