Cognitive function in patients with diabetes mellitus: guidance for daily care.
Diabetes mellitus is associated with an increase in the risk of dementia and the proportion of patients who convert from mild cognitive impairment (MCI) to dementia. In addition to MCI and dementia, the stages of diabetes-associated cognitive dysfunction include subtle cognitive changes that are unlikely to affect activities of daily life or diabetes self-management. These diabetes-associated cognitive decrements have structural brain correlates detectable with brain MRI, but usually show little progression over time. Although cognitive decrements do not generally represent a pre-dementia stage in patients below the age of 60-65 years, in older individuals these subtle cognitive changes might represent the earliest stages of a dementia process. Acknowledgment of diabetes-associated cognitive decrements can help to improve understanding of patients' symptoms and guide management. Future challenges are to establish the importance of screening for cognitive impairment in people with diabetes, to identify those at increased risk of accelerated cognitive decline at an early stage, and to develop effective treatments.
Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Netherlands.
Paula S
PS
Koekkoek
Department of Neurology, Brain Center Rudolf Magnus, University Medical Centre Utrecht, Netherlands. Electronic address: l.kappelle@umcutrecht.nl.
L Jaap
LJ
Kappelle
Department of Neurology, Brain Center Rudolf Magnus, University Medical Centre Utrecht, Netherlands; Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, Netherlands.
Esther
E
van den Berg
Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Netherlands.
Guy E H M
GE
Rutten
Department of Neurology, Brain Center Rudolf Magnus, University Medical Centre Utrecht, Netherlands.
Geert Jan
GJ
Biessels
D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D006801:Humans; D005791:Patient Care / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*