title: The impact of diabetes on cognitive decline: potential vascular, metabolic, and psychosocial risk factors.
abstract: Older people with type 2 diabetes are at increased risk of developing cognitive impairment, for which several potential risk factors have been proposed. The present article reviews evidence in people with type 2 diabetes for associations of cognitive impairment with a range of vascular, metabolic, and psychosocial risk factors, many of which have a higher prevalence in people with type 2 diabetes than in non-diabetic adults of a similar age. Definitive research studies in this field are few in number. The risk factors may be involved in causal pathways or may act as useful markers of cerebrovascular damage (or both), and for which relatively consistent evidence is available, include poor glycemic control, hypoglycemia, microvascular disease, inflammation, and depression. For macrovascular disease, the strength of the association with cognitive impairment appears to depend on which vascular system has been examined. A role for pre-morbid ability in young adulthood as influencing the risk of both diabetes and cognitive impairment has also been suggested. The importance of considering inter-relationships between risk factors when investigating their potential contribution to cognitive impairment in future investigations is discussed.
authors.affiliation: Centre for Population Health Sciences, Medical School, Teviot Place, Edinburgh, EH8 9AG Scotland UK.
authors.forename: Insa
authors.initials: I
authors.lastname: Feinkohl
authors.affiliation: Centre for Population Health Sciences, Medical School, Teviot Place, Edinburgh, EH8 9AG Scotland UK.
authors.forename: Jackie F
authors.initials: JF
authors.lastname: Price
authors.affiliation: Metabolic Unit, Western General Hospital, Crewe Road South, Edinburgh, EH4 2XU Scotland UK.
authors.forename: Mark W J
authors.initials: MW
authors.lastname: Strachan
authors.affiliation: The Queen's Medical Research Institute, University of Edinburgh, College of Medical and Veterinary Medicine, 47 Little France Crescent, Edinburgh, EH16 4TJ Scotland UK.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Frier