Could Midlife Diabetes Diagnosis Speed Cognitive Decline?

Findings from Johns Hopkins Bloomberg School of Public Health researchers indicate that a diagnosis of diabetes in midlife may hasten the rate of cognitive decline over the following 20 years.

Led by Elizabeth Selvin, PhD, an associate professor of epidemiology at Johns Hopkins, a team of investigators analyzed data from the Atherosclerosis Risk in Communities study, which included 15,792 middle-aged adults who had been followed since 1987. Participants’ health was assessed over the span of 4 visits taking place approximately 3 years apart, between the years 1987 and 1998. A fifth assessment was done between 2011 and 2013. The authors also analyzed patients’ cognitive function on 3 of these assessments, which occurred between 1990 and 1992, 1996 and 1998, and 2011 and 2013.
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What their analysis revealed suggests that “if we better control diabetes and prevent people from developing diabetes now, we may be able to stave off cognitive decline in later years,” says Selvin.

Selvin and colleagues compared the rate of cognitive decline in study participants with that of age-related cognitive decline among the general population, finding that participants with poorly controlled diabetes were 19% more likely to experience cognitive decline, including reduced memory, word recall, and executive functioning, in comparison to those of the same age but without diabetes. According to the authors, this essentially equates to patients with poorly controlled diabetes experiencing cognitive decline nearly 5 years sooner than healthy individuals at the same age.

Selvin and company also found study participants with controlled or pre-diabetes were at greater risk of cognitive decline than healthy individuals of the same age, although the higher risk among these populations was not as pronounced as that found among those with poorly controlled diabetes.

These results “support a vascular basis for dementia,” says Selvin, “and suggest that major cardiovascular risk factors, such as diabetes, are major contributors to the development of later-life cognitive decline.”

—Mark McGraw

Reference

Selvin E, Ning Y, et al. Diabetes in midlife and cognitive change over 20 years: the Atherosclerosis Risk in Communities Neurocognitive Study. Annals of Internal Medicine. 2014.