title: The interaction of age and type 2 diabetes on executive function and memory in persons aged 35 years or older.
abstract: It is generally assumed that type 2 diabetes increases the risk of cognitive dysfunction in old age. As type 2 diabetes is frequently diagnosed before the age of 50, diabetes-related cognitive dysfunction may also occur before the age of 50. Therefore, we investigated the association of type 2 diabetes with cognitive function in people aged 35-82 years. In a cross-sectional study comprising 4,135 participants of the Prevention of Renal and Vascular ENd-stage Disease study (52% men; mean age (SD), 55 (12) years) diabetes was defined according to the criteria of the American Diabetes Association. Executive function was measured with the Ruff Figural Fluency Test (RFFT; worst score, 0 points; best score, 175 points), and memory was measured with the Visual Association Test (VAT; worst score, 0 points; best score, 12 points). The association of diabetes with cognitive function was investigated with multiple linear or, if appropriate, logistic regression analysis adjusting for other cardiovascular risk factors and APOE ε4 carriership. Type 2 diabetes was ascertained in 264 individuals (6%). Persons with diabetes had lower RFFT scores than persons without diabetes: mean (SD), 51 (19) vs. 70 (26) points (p<0.001). The difference in RFFT score was largest at age 35-44 years (mean difference 32 points; 95% CI, 15 to 49; p<0.001) and gradually decreased with increasing age. The association of diabetes with RFFT score was not modified by APOE ε4 carriership. Similar results were found for VAT score as outcome measure although these results were only borderline statistically significant (p≤0.10). In conclusion, type 2 diabetes was associated with cognitive dysfunction, especially in young adults. This was independent of other cardiovascular risk factors and APOE ε4 carriership.
authors.affiliation: University of Groningen, University Medical Center Groningen, University Center for Geriatric Medicine, Groningen, The Netherlands.
authors.forename: Marlise E A
authors.initials: ME
authors.lastname: van Eersel
authors.affiliation: University of Groningen, University Medical Center Groningen, University Center for Geriatric Medicine, Groningen, The Netherlands ; University of Groningen, University Medical Center Groningen, Department of Nephrology, Groningen, The Netherlands.
authors.forename: Hanneke
authors.initials: H
authors.lastname: Joosten
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Nephrology, Groningen, The Netherlands.
authors.forename: Ron T
authors.initials: RT
authors.lastname: Gansevoort
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Endocrinology, Groningen, The Netherlands.
authors.forename: Robin P F
authors.initials: RP
authors.lastname: Dullaart
authors.affiliation: University of Groningen, University Medical Center Groningen, University Center for Geriatric Medicine, Groningen, The Netherlands ; University of Groningen, University Medical Center Groningen, Alzheimer Center Groningen, Groningen, The Netherlands.
authors.forename: Joris P J
authors.initials: JP
authors.lastname: Slaets
authors.affiliation: University of Groningen, University Medical Center Groningen, University Center for Geriatric Medicine, Groningen, The Netherlands ; University of Groningen, University Medical Center Groningen, Alzheimer Center Groningen, Groningen, The Netherlands.
authors.forename: Gerbrand J
authors.initials: GJ
authors.lastname: Izaks
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D001057:Apolipoproteins E / Q000235:genetics; D002318:Cardiovascular Diseases / Q000150:complications; D003071:Cognition; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000235:genetics / Q000503:physiopathology*; D056344:Executive Function; D005260:Female; D006579:Heterozygote; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D012307:Risk Factors
chemical_list: D001057:Apolipoproteins E