title: Relationship Between Type 2 Diabetes Mellitus and Cognitive Change in a Multiethnic Elderly Cohort.
abstract: OBJECTIVE
  To examine the association between diabetes mellitus and cognitive functioning at baseline and cognitive change over time in a large, ethnically diverse sample of older adults.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Washington Heights-Inwood Columbia Aging Project, a community-based, prospective study of risk factors for dementia in northern Manhattan, New York City.
  
  
  METHODS
  Hispanic, non-Hispanic black, and non-Hispanic white men and women aged 65 and older without dementia at baseline (N = 1,493).
  
  
  METHODS
  Participants underwent baseline and follow-up cognitive and health assessments approximately every 18 months. Generalized estimating equations were used to examine the longitudinal association between diabetes mellitus and cognition.
  
  
  RESULTS
  Diabetes mellitus was associated with poorer baseline cognitive performance in memory, language, processing speed and executive functioning, and visuospatial abilities. After adjusting for age, education, sex, race and ethnicity, and apolipoprotein-ε4, participants with diabetes mellitus performed significantly worse at baseline than those without in language and visuospatial abilities. There were no differences between those with and without diabetes mellitus in terms of rate of cognitive change over a mean follow-up time of 6 years.
  
  
  CONCLUSIONS
  The rate of cognitive change in elderly persons with and without diabetes mellitus is similar, although cognitive performance is poorer in persons with diabetes mellitus. These findings suggest that cognitive changes may occur early during the diabetes mellitus process and highlight the need for studies to follow participants beginning at least in midlife, before the typical later-life onset of dementia.
authors.affiliation: Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California.|Department of Psychiatry, University of California at San Diego, La Jolla, California.
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Bangen
authors.affiliation: Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York.
authors.forename: Yian
authors.initials: Y
authors.lastname: Gu
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Alden L
authors.initials: AL
authors.lastname: Gross
authors.affiliation: Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.
authors.forename: Brooke C
authors.initials: BC
authors.lastname: Schneider
authors.affiliation: Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Jeannine C
authors.initials: JC
authors.lastname: Skinner
authors.affiliation: Department of Radiology and Radiological Sciences, Center for Biomedical Imaging, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Andreana
authors.initials: A
authors.lastname: Benitez
authors.affiliation: Department of Neurology, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
authors.forename: Bonnie C
authors.initials: BC
authors.lastname: Sachs
authors.affiliation: RAND Corporation, Arlington, Virginia.
authors.forename: Regina
authors.initials: R
authors.lastname: Shih
authors.affiliation: North Florida/South Georgia Veterans Health System, Gainesville, Florida.
authors.forename: Shannon
authors.initials: S
authors.lastname: Sisco
authors.affiliation: Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York.|Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, New York.|Gertrude H. Sergievsky Center, Columbia University, New York, New York.
authors.forename: Nicole
authors.initials: N
authors.lastname: Schupf
authors.affiliation: Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York.|Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, New York.|Gertrude H. Sergievsky Center, Columbia University, New York, New York.|Departments of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York.|Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York.
authors.forename: Richard
authors.initials: R
authors.lastname: Mayeux
authors.affiliation: Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York.|Gertrude H. Sergievsky Center, Columbia University, New York, New York.|Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Manly
authors.affiliation: Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, New York.|Medicine, College of Physicians and Surgeons, Columbia University, New York, New York.
authors.forename: José A
authors.initials: JA
authors.lastname: Luchsinger
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis* / Q000208:ethnology*; D015331:Cohort Studies; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000523:psychology; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health / Q000208:ethnology*; D044465:White People / Q000706:statistics & numerical data
keywords: aging; cognition; diabetes mellitus; vascular risk factors