Cognitive performance of older adults in a specialized diabetes clinic.
BACKGROUND
Diabetes mellitus is a risk factor for cognitive changes, but assessment for cognitive disorders in this population is performed infrequently. The present study examined the frequency of cognitive disorders and patterns of deficit in patients enrolled in a specialized clinic for diabetes.


METHODS
A cross-sectional study was conducted to assess cognition in Mount Sinai Diabetes Center patients. Thirty eligible subjects aged ≥50 years were assessed and compared with non-diabetic cognitively normal control subjects, as well as non-diabetic subjects with mild cognitive impairment (MCI). The main outcome(s) and measure(s) were obtained through cognitive assessment and diagnosis using the Alzheimer's Disease Centers' uniform data set.


RESULTS
Forty percent of subjects were newly diagnosed with a cognitive disorder: 10% were diagnosed with dementia and 30% with MCI. Diabetic subjects performed worse on the Mini-Mental State Examination (27.2 vs 28.4; P = 0.0132), list generation (9.5 vs 12.2; P = 0.0190), Trail Making Test, Parts A (70.1 vs 43.0; P < 0.0001) and B (197.2 vs 123.6; P < 0.0001), and the Digit Symbol test (12.7 vs 40.1; P < 0.0001) than cognitively normal individuals. Compared with subjects with MCI (amnestic type), diabetic subjects performed better on tasks of immediate and delayed recall (11.2 vs 7.3 [P = 0.0048] and 8.4 vs. 4.1 [P = 0.0003], respectively).


CONCLUSIONS
Undiagnosed cognitive disorders are common and underappreciated in patients being treated in a specialized diabetes clinic. It may be important to make cognitive assessment a standard part of patient assessments.
Department of Psychiatry, Alzheimer's Disease Research Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA.|James J. Peters VA Medical Center, New York, New York, USA.
Corbett
C
Schimming
Department of Psychiatry, Alzheimer's Disease Research Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA.|James J. Peters VA Medical Center, New York, New York, USA.
Xiaodong
X
Luo
Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Cen
C
Zhang
Department of Psychiatry, Alzheimer's Disease Research Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA.|James J. Peters VA Medical Center, New York, New York, USA.
Mary
M
Sano
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006782:Hospitals, Special / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012307:Risk Factors

Alzheimer's disease; 2型糖尿病; cognition; dementia; diabetes-related complications; type 2 diabetes mellitus; 痴呆; 糖尿病相关的并发症; 认知; 阿尔茨海默病