Effects of Diabetes Mellitus on Neuropsychological Functioning: A Lifespan Perspective

Children and adults with diabetes mellitus have an elevated risk of manifesting mild cognitive deficits. Taking a lifespan approach, this review posits that diabetes-related biomedical and psychosocial risk factors interact with age to produce somewhat different patterns of neuropsychological dysfunction. In children and adolescents with diabetes, neuropsychological dysfunction is a consequence of two very different types of risk factors: mild to moderate hypoglycemic episodes that affect the developing nervous system, and psychosocial and psychoeducational disruption that interferes with the acquisition of knowledge about the world. In adults with IDDM, cognitive impairments may be associated independently with chronic hyperglycemia-as indexed by glycosylated hemoglobin levels or by the presence of biomedical complications, or with repeated episodes of moderately severe hypoglycemia. In older adults with NIDDM, the critical risk factor is chronic hyperglycemia, but it is associated with the development of a broader range of cognititve impairments than has been reported for younger adults with IDDM.