Background and Objectives: Type 2 diabetes, which is highly prevalent in older Mexican Americans, may influence cognitive functioning. We examined the association of diabetes with decline in global cognitive function and memory function over a 2-year period.
Methods: Study subjects were derived from an existing cohort of Latinos aged 60 and over in the SALSA project (n = 1,789). Statistical analysis was conducted using logistic regression and a generalized estimating equation (GEE).
Results: Logistic regression analysis indicated that baseline diabetes was a significant predictor of major cognitive impairment in Modified Mini Mental State Exam (3MSE) (OR = 1.68, 95% CI = 1.21, 2.34) and word-list test (OR = 1.31, 95% CI = 0.99, 1.75). GEE analysis showed that there was no significant difference between diabetic and nondiabetic subjects in change of cognitive scores over 2 years (3MSE, mean = −0.58, 95% CI = −1.48, 0.32; word-list test, mean = −0.10, 95% CI = −0.32, 0.11).
Conclusions: More diabetic complications were associated with major cognitive decline among diabetic subjects. Research on long-term impact of treatment for type 2 diabetes is warranted.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Clinical Epidemiology
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Population by age, Hispanic origin, race, and sex: March 1999.Current Population Survey Internet release. Vol. 8. U.S. Census Bureau, Washington (DC)2000 (p. 99)
- Diabetes among Mexican-Americans in Starr County, Texas.Am J Epidemiol. 1983; 118: 649-672
- Does obesity explain excess prevalence of diabetes among Mexican Americans? Results of the San Antonio Heart Study.Diabetologia. 1983; 24: 272-277
- Methods and prevalence of non-insulin-dependent diabetes mellitus in a biethnic Colorado population: The San Luis Valley Diabetes Study.Am J Epidemiol. 1989; 129: 295-311
- Prevalence of diabetes in Mexican Americans, Cubans, and Puerto Ricans from the Hispanic Health and Nutrition Examination Survey, 1982–1984.Diabetes Care. 1991; 14: 628-638
- Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in US adults: The Third National Health and Nutrition Examination Survey (NHANES), 1988–94.Diabetes Care. 1998; 21: 518-524
- Summary.in: 2nd ed. Diabetes in America. Vol. 1. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda1995: 1-14
- Non-insulin-dependent diabetes mellitus in minorities in the United States.Ann Intern Med. 1996; 125: 221-232
- Relationship of hemoglobin A1c, age of diabetes diagnosis, and ethnicity to clinical outcomes and medical costs in a computer—simulated cohort of persons with type 2 diabetes.Am J Manage Care. 2000; 6: 573-584
- Increased health burden associated with comorbid depression in older diabetic Mexican Americans. Results from the Hispanic Established Population for the Epidemiologic Study of the Elderly survey.Diabetes Care. 1999; 22: 56-64
- Decreased cognitive function in aging non-insulin-dependent diabetic patients.Am J Med. 1984; 77: 1043-1048
- Cortical function in elderly non-insulin dependent diabetic patients. Behavioral and electrophysiologic studies.Arch Intern Med. 1988; 148: 2369-2372
- Effect of type II diabetes mellitus on cognitive function.J Fam Pract. 1993; 36: 639-643
- Diabetes and cognitive impairment: a community-based study of elderly subjects.Age Aging. 1995; 24: 421-424
- The influence of diabetes, hypertension, and stroke on ethnic differences in physical and cognitive functioning in an ethnically diverse older population.Annals of Epidemiology. 1996; 6: 392-398
- Is diabetes associated with cognitive impairment and cognitive decline among older women? The Study of Osteoporotic Fractures Research Group.Arch Intern Med. 2000; 160: 174-180
- The role of APOE epsilon4 in modulating effects of other risk factors for cognitive decline in elderly persons.JAMA. 1999; 282: 40-46
- Is type II diabetes associated with an increased risk of cognitive dysfunction? A critical review of published studies.Diabetes Care. 1997; 20: 438-445
- Cognitive impairment and the use of health services in an elderly rural population: the MOVIES Project.J Am Geriatr Soc. 1993; 41: 1065-1070
- Cognitive impairment and mortality in a cohort of elderly people.BMJ. 1996; 312: 608-611
- Risk factors for 5-year mortality in older adults: the Cardiovascular Health Study.JAMA. 1998; 279: 585-592
- Cognitive function and the costs of Alzheimer disease: an exploratory study.Arch Neurol. 1997; 54: 687-693
- Estimating the costs of caring for people with Alzheimer disease in California: 2000–2040.J Public Health Policy. 2001; 22: 88-97
- How much do persons with Alzheimer's disease cost Medicare?.J Am Geriatr Soc. 2000; 48: 639-646
- Cognitive function and metabolic state in elderly diabetic patients.Diabetes Nutr Metab. 1992; 5: 265-274
- Insurin hiizon-gata tounyoubyou kanja ni okeru no kino shogai no kento.No To Shinkei. 1995; 47: 543-548
- Deterioramento mentale in soggetti anziani con diabete tipo II.G Clin Med. 1986; 67: 21-23
- “Mini-Mental State”: a practical method of grading the cognitive function of patients for the clinician.J Psychiatr Res. 1978; 12: 189-198
- Racial and ethnic differences in health care access and health outcomes for adults with type 2 diabetes.Diabetes Care. 2001; 24: 454-459
- Factors affecting diabetes treatment and patient education among Latinos: results of a preliminary study in Chicago.J Med Syst. 1996; 20: 267-276
- The role of blood flow in diabetic vascular disease.in: Rifkin H. Porte D. Diabetes mellitus theory and practice. 4th ed. Elsevier, New York1990
- Prevalence of dementia in older Mexican Americans.J Am Geriatr Soc. 2003; 51: 169-177
- The Modified Mini-Mental State (3MS) examination.J Clin Psychiatry. 1987; 48: 314-318
- Development of psychometrically matched English and Spanish language neuropsychological tests for older persons.Neuropsychology. 2000; 14: 209-223
- A new verbal learning and memory test for English- and Spanish-speaking older people.J Int Neuropsychol Soc. 2001; 7: 544-555
- The Ces-D scale: a self-report depression scale for research in the general population.Applied Psychological Measurement. 1977; 1: 385-401
- Acculturation rating scale for Mexican Americans-II: a revision of the original ARSMA Scale.Hispanic J Behav Sci. 1995; 17: 275-304
- Multiple imputation for multivariate missing-data problems: a data analyst's perspective.Multivar Behav Res. 1998; 33: 545-571
- Analytics of incomplete multivariate data. Chapman & Hall, London1997
- Multiple imputation for nonresponse in surveys. J. Wiley & Sons, New York1987
- Predictors of decline in MMSE scores among older Mexican Americans.J Gerontol Med Sci. 2002; 57A: M181-M185
© 2003 Elsevier Inc. Published by Elsevier Inc. All rights reserved.