title: Association of diabetes mellitus and mild cognitive impairment in middle-aged men and women.
abstract: BACKGROUND
  Several studies reported on the association of type 2 diabetes (T2DM) with dementia. Studies on the association of T2DM and mild cognitive impairment (MCI) are rare.
  
  
  OBJECTIVE
  To evaluate the gender-specific association of T2DM with MCI and MCI subtypes (amnestic MCI (aMCI) and non-amnestic MCI (naMCI)) in a middle-aged (50-65 years) and old-aged (66-80 years) population-based study sample.
  
  
  METHODS
  We compared 560 participants with MCI (aMCI n = 289, naMCI n = 271) with 1,376 cognitively normal participants from the Heinz Nixdorf Recall study. Diabetic status was based on self-reported physician's diagnosis or treatment with anti-diabetic medication. We performed group comparisons regarding all cognitive subtests for participants with and without T2DM. Logistic regression models (adjusted for age, education, cardiovascular risk factors, and depression) were used to determine the association of T2DM with MCI and MCI subtypes.
  
  
  RESULTS
  In the middle-aged group, fully adjusted models showed an association (odds ratio, 95% CI) of T2DM with MCI that was more pronounced in men (total: 2.03, 1.23-3.36, men: 2.16, 1.12-4.14, women 1.69, 0.73-3.89). T2DM was associated with MCI subtypes (aMCI: 2.01, 1.08-3.73; naMCI: 2.06, 1.06-3.98), whereas, the association was stronger with naMCI in men (2.61, 1.14-5.98) and with aMCI in women (3.02, 1.27-7.17). We found no total or gender-specific association of T2DM with MCI or MCI subtypes in the old-aged group.
  
  
  CONCLUSIONS
  Our data show that T2DM is associated with MCI and MCI subtypes in middle-aged, but not in old-aged participants. Furthermore, the results indicate a gender-specific vulnerability of T2DM on cognition, especially in MCI subtypes.
authors.affiliation: Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany.
authors.forename: Angela
authors.initials: A
authors.lastname: Winkler
authors.affiliation: Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany.
authors.forename: Martha
authors.initials: M
authors.lastname: Dlugaj
authors.affiliation: Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Weimar
authors.affiliation: Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Jöckel
authors.affiliation: Clinic of Cardiology, West German Heart Centre, University Hospital of Essen, University Duisburg-Essen, Essen, Germany.
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
authors.affiliation: Institute for Medical Sociology, Centre for Healthy and Society, University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Nico
authors.initials: N
authors.lastname: Dragano
authors.affiliation: Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Moebus
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012307:Risk Factors; D012737:Sex Factors
keywords: Aging; gender; mild cognitive impairment; population-based studies; type 2 diabetes mellitus