A Link between Diabetes and Mild Cognitive Impairment?

Robert W. Griffith, MD

Three weeks ago I posted an item on mild cognitive impairment, or MCI. It seems that there are already minute structural changes in the brain before MCI is readily diagnosed by neuropsychiatric tests. Now there's a report that type 2 diabetes is associated with the development of amnestic MCI. It was published in the Archives of Neurology by researchers at Columbia University Medical Center, New York.

Over 900 healthy people over 65 were followed for an average of 6 years; every 18 months they had a full medical assessment. During the study 334 subjects developed MCI -160 amnestic and 174 non-amnestic MCI. There were 202 (24%) diabetics among the participants. The average age of the participants was 75, and 70% of them were women.

After adjustments for known risk factors for MCI - sex, years of education, ethnic group, apolipoprotein E-4 allele, high blood pressure, raised low density lipoprotein, current smoking, heart disease, and stroke - it was shown that diabetes was related to a significantly higher risk of MCI (both types pooled). It was also related to a higher risk of amnestic MCI, but only to nonamnestic MCI when some of the known risk factors were not included (e.g. education level, ethnicity, vascular disease). African Americans and Hispanics were more likely to have diabetes-related MCI.

This is pretty gloomy news, in view of the increasing numbers of type 2 diabetics anticipated in future decades. It drives home the messages about lifestyle changes to avoid diabetes as well as the other known risk factors for MCI and Alzheimer's. (Is anyone still talking about the metabolic syndrome these days?)

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HealthandAge Blog

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