title: Cognitive disorders in diabetic patients.
abstract: This chapter gives an overview of the literature on cognitive dysfunction in adults with type 1 or type 2 diabetes. First, methods to evaluate cognitive functioning and the pattern and severity of cognitive dysfunction in relation to diabetes will be discussed. The reader will note that diabetes is associated with worse cognitive functioning and an increased dementia risk. Next, diabetes-associated abnormalities on brain MRI, including reductions in brain volume - i.e., cerebral atrophy - and vascular lesions, will be addressed. At the group level there are clear relations between these imaging abnormalities and cognitive dysfunction, but at the level of the individual patient these relations are often less clear. Subsequently, risk factors for cognitive performance will be discussed. Evidently, these risk factors are related to diabetes type and the age of the patients involved. For type 1 diabetes, an early age at diabetes onset is the most consistent risk factor, whereas in type 2 diabetes, vascular risk factors and vascular comorbidities are consistent indicators of increased risk. The final section of the chapter addresses possible preventive and treatment measures and implications for daily care.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Paula S
authors.initials: PS
authors.lastname: Koekkoek
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Guy E H M
authors.initials: GE
authors.lastname: Rutten
authors.affiliation: Department of Neurology, Rudolf Magnus Institute of Neurosciences, University Medical Center Utrecht, The Netherlands. Electronic address: g.j.biessels@umcutrecht.nl.
authors.forename: Geert Jan
authors.initials: GJ
authors.lastname: Biessels
mesh_terms: D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D006801:Humans; D008137:Longitudinal Studies; D009483:Neuropsychological Tests; D012307:Risk Factors
keywords: Alzheimer's disease; Type 1 diabetes; brain MRI; cognitive functioning; dementia; risk factors; type 2 diabetes