Generic placeholder image

Current Aging Science

Editor-in-Chief

ISSN (Print): 1874-6098
ISSN (Online): 1874-6128

Research Article

The Association Between Diabetes and Cognitive Function in Later Life

Author(s): Yadollah A. Momtaz, Tengku A. Hamid*, Mohamad F. Bagat and Maryam Hazrati

Volume 12, Issue 1, 2019

Page: [62 - 66] Pages: 5

DOI: 10.2174/1874609812666190614104328

Abstract

Introduction: Although diabetes through several possible mechanisms such as increased microvascular pathology and inefficiency of glucose utilization during cognitive tasks can be associated with cognitive impairment, there is inconclusive evidence that shows elderly diabetic patients under therapy have higher cognitive function compared to their non-diabetics counterparts. The present study was conducted to elucidate the association between diabetes and cognitive function in later life.

Methods: Data for this study, consisting of 2202 older adults aged 60 years and above, were taken from a population-based survey entitled “Identifying Psychosocial and Identifying Economic Risk Factor of Cognitive Impairment among Elderly. Data analysis was conducted using the IBM SPSS Version 23.0.

Results: The mean of MMSE was found to be 22.67 (SD = 4.93). The overall prevalence of selfreported diabetes was found to be 23.6% (CI95%: 21.8% - 25.4%). The result of independent t-test showed diabetic subjects had a higher mean score of MMSE (M = 23.05, SD =4 .55) than their counterparts without diabetes (M = 22.55, SD = 5.04) (t = -2.13 p<.05). The results of multiple linear regression analysis showed that diabetes was not significantly associated with cognitive function, after controlling the possible confounding factors.

Conclusions: The findings from the current study revealed that diabetes is not associated with cognitive decline. This study supports the findings that long-term treatment of diabetes may reduce the risk of cognitive decline. This finding may provide new opportunities for the prevention and management of cognitive decline.

Keywords: Aged, diabetes, cognitive function, microvascular pathology, cognitive impairment, MMSE.

Graphical Abstract

[1]
Luchsinger JA. Diabetes, related conditions, and dementia. J Neurol Sci 2010; 299(1): 35-8.
[2]
Natan MB, Danino S, Freundlich N, Barda A, Yosef RM. Intention of nursing students to work in geriatrics. Res Gerontol Nurs 2015; 8(3): 140-7.
[3]
Peila R, Rodriguez BL, Launer LJ. Type 2 diabetes, APOE gene, and the risk for dementia and related pathologies. The Honolulu-Asia Aging Study Diabetes 2002; 51(4): 1256-62.
[4]
Akomolafe A, Beiser A, Meigs JB, Au R, Green RC, Farrer LA, et al. Diabetes mellitus and risk of developing Alzheimer disease: Results from the framingham study. Arch Neurol 2006; 63(11): 1551-5.
[5]
Cheng D, Noble J, Tang MX, Schupf N, Mayeux R, Luchsinger JA. Type 2 diabetes and late-onset alzheimer’s disease. Dement Geriatr Cogn Disord 2011; 31(6): 424-30.
[6]
Patrone C, Eriksson O, Lindholm D. Diabetes drugs and neurological disorders: New views and therapeutic possibilities. Lancet Diabetes Endocrinol 2014; 2(3): 256-62.
[7]
Markowicz-Piasecka M, Sikora J, Szydłowska A, Skupień A, Mikiciuk-Olasik E, Huttunen KM. Metformin- A future therapy for neurodegenerative diseases. Pharm Res 2017; 34(12): 2614-27.
[8]
Ascher-Svanum H, Chen YF, Hake A, Kahle-Wrobleski K, Schuster D, Kendall D, et al. Cognitive and functional decline in patients with mild alzheimer dementia with or without comorbid diabetes. Clin Therapeut 2015; 37(6): 1195-205.
[9]
Banks WA, Owen JB, Erickson MA. Insulin in the brain: There and back again. Pharmacol Ther 2012; 136(1): 82-93.
[10]
Li J, Cesari M, Liu F, Dong B, Vellas B. Effects of diabetes mellitus on cognitive decline in patients with Alzheimer disease: A systematic review. Can J Diabetes 2017; 41(1): 114-9.
[11]
Strachan MW, Reynolds RM, Frier BM, Mitchell RJ, Price JF. The relationship between type 2 diabetes and dementia. Br Med Bull 2008; 88(1): 131-46.
[12]
González-Reyes ER, Aliev G, Ávila-Rodrigues M, Barreto EG. Alterations in glucose metabolism on cognition: A possible link between diabetes and dementia. Curr Pharm Des 2016; 22(7): 812-8.
[13]
Bowling A. Research methods in health: Investigating health and health services. 4th ed. Milton Keynes: Open University Press 2014.
[14]
Hsu CC, Wahlqvist ML, Lee MS, Tsai HN. Incidence of dementia is increased in type 2 diabetes and reduced by the use of sulfonylureas and metformin. J Alzheimers Dis 2011; 24(3): 485-93.
[15]
Bruce DG, Davis WA, Casey GP, Starkstein SE, Clarnette RM, Foster J, et al. Predictors of cognitive impairment and dementia in older people with diabetes. Diabetologia 2008; 51(2): 241-8.
[16]
Herath PM, Cherbuin N, Eramudugolla R, Anstey KJ. The effect of diabetes medication on cognitive function: evidence from the PATH Through Life study. BioMed Res Int 2016; 20167208429
[17]
Asadbegi M, Yaghmaei P, Salehi I, Ebrahim-Habibi A, Komaki A. Neuroprotective effects of metformin against Aβ-mediated inhibition of long-term potentiation in rats fed a high-fat diet. Brain Res Bull 2016; 121: 178-85.
[18]
Gupta A, Bisht B, Dey CS. Peripheral insulin-sensitizer drug metformin ameliorates neuronal insulin resistance and Alzheimer’s-like changes. Neuropharmacology 2011; 60(6): 910-20.
[19]
Imfeld P, Bodmer M, Jick SS, Meier CR. Metformin, other antidiabetic drugs, and risk of Alzheimer’s disease: A population-based case-control study. J Am Geriatr Soc 2012; 60(5): 916-21.
[20]
Momtaz YA, Hamid TA, Haron SA, Bagat MF. Flourishing in later life. Arch Gerontol Geriatr 2016; 63: 85-91.
[21]
Shahar S, Omar A, Vanoh D, Hamid TA, Mukari SZMS, Din NC, et al. Approaches in methodology for population-based longitudinal study on neuroprotective model for healthy longevity (TUA) among Malaysian Older Adults. Aging Clin Exp Res 2016; 28(6): 1089-104.
[22]
Ibrahim NM, Shohaimi S, Chong HT, Rahman AH, Razali R, Esther E, et al. Validation study of the mini-mental state examination in a Malay-speaking elderly population in Malaysia. Dement Geriatr Cogn Disord 2009; 27(3): 247-53.
[23]
Yuan X, Liu T, Wu L, Zou ZY, Li C. Validity of self-reported diabetes among middle-aged and older Chinese adults: The China health and retirement longitudinal study. BMJ Open 2015; 5(4)e006633
[24]
Keel S, Foreman J, Xie J, van Wijngaarden P, Taylor HR, Dirani M. The prevalence of self-reported diabetes in the Australian national eye health survey. PLoS One 2017; 12(1)e0169211
[25]
Xaverius PK, Salas J, Kiel D. Differences in pregnancy planning between women aged 18-44, with and without diabetes: Behavioral risk factor surveillance system analysis. Diabetes Res Clin Pract 2013; 99(1): 63-8.
[26]
Hamid TA, Krishnaswamy S, Abdullah SS, Momtaz YA. Sociodemographic risk factors and correlates of dementia in older Malaysians. Dement Geriatr Cogn Disord 2010; 30(6): 533-9.
[27]
Momtaz YA, Hamid TA, Yusoff S, Ibrahim R. Do depression and educational attainment mediate the association between ethnicity and dementia? Gerontology 2013; 59(3): 206-12.
[28]
Kim HY. Statistical notes for clinical researchers: Assessing normal distribution (2) using skewness and kurtosis. Restor Dent Endod 2013; 38(1): 52-4.
[29]
Francisco PM, Belon AP, Barros MB, Carandina L, Alves MC, Goldbaum M, et al. Self-reported diabetes in the elderly: Prevalence, associated factors, and control practices. Public Health Notebooks 2010; 26(1): 175-84.
[30]
Rampal S, Rampal L, Rahmat R, Zain AM, Yap YG, Mohamed M, et al. Variation in the prevalence, awareness, and control of diabetes in a multiethnic population: A nationwide population study in Malaysia. Asia Pac J Public Health 2010; 22(2): 194-202.
[31]
Cukierman T, Gerstein HC, Williamson JD. Cognitive decline and dementia in diabetes- Systematic overview of prospective observational studies. Diabetologia 2005; 48(12): 2460-9.
[32]
Stewart R, Liolitsa D. Type 2 diabetes mellitus, cognitive impairment and dementia. Diabet Med 1999; 16(2): 93-112.
[33]
Cheng G, Huang C, Deng H, Wang H. Diabetes as a risk factor for dementia and mild cognitive impairment: A meta‐analysis of longitudinal studies. Intern Med J 2012; 42(5): 484-91.
[34]
Hasan SS. A comparative drug utilisation study of the treatment of diabetes in Malaysia and Australia. Australas Med J 2015; 8(6): 179-88.
[35]
Campbell JM, Stephenson MD. Courten Bd, Chapman I, Bellman SM, Aromataris E. Metformin use associated with reduced risk of dementia in patients with diabetes: A systematic review and meta-analysis. J Alzheimers Dis 2018; 65(4): 1225-36.
[36]
Ng TP, Feng L, Yap KB, Lee TS, Tan CH, Winblad B. Long-term metformin usage and cognitive function among older adults with diabetes. J Alzheimers Dis 2014; 41(1): 61-8.
[37]
Podhorecka M, Ibanez B, Dmoszyńska A. Metformin- Its potential anti-cancer and anti-aging effects. Postepy Hig Med Dosw 2017; 71: 170-5.
[38]
Chen Y, Zhou K, Wang R, Liu Y, Kwak YD, Ma T, et al. Antidiabetic drug metformin (GlucophageR) increases biogenesis of Alzheimer's amyloid peptides via up-regulating BACE1 transcription. Proc Natl Acad Sci USA 2009; 106(10): 3907-12.
[39]
Campbell JM, Stephenson MD, de Courten B, Chapman I, Bellman SM, Aromataris E. Metformin and Alzheimer’s disease, dementia and cognitive impairment: A systematic review protocol. JBI Database System Rev Implement Rep 2017; 15(8): 2055-9.
[40]
Okura Y, Urban LH, Mahoney DW, Jacobsen SJ, Rodeheffer RJ. Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure. J Clin Epidemiol 2004; 57(10): 1096-103.

© 2024 Bentham Science Publishers | Privacy Policy