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Diabetes is associated with increased rate of cognitive decline in questionably demented elderly
Ramit Ravona-Springer1, Xiaodong Luo, James Schmeidler
1Memory Clinic, Sheba Medical Center, Ramat Gan, Israel. ramit.ravona@sheba.health.gov.il
Background:
This study examines whether the association of diabetes with the rate of cognitive decline varies according to dementia severity.
Methods:
Longitudinal study on subjects residing in nursing homes and assisted living (n = 342). The Mini Mental State Examination (MMSE) was used to measure the rate of cognitive decline in diabetic and nondiabetic subjects who were nondemented (Clinical Dementia Rating, CDR = 0; n = 125), questionably demented (CDR = 0.5; n = 58) or frankly demented (CDR > or =1; n = 89) at baseline. Diagnosis of diabetes was ascertained by review of medical records and history.
Results:
Diabetes was associated with an increased rate of decline in the MMSE score of questionably demented subjects (p < 0.0001). In frankly demented subjects, diabetes tended to be associated with less cognitive decline (p = 0.04). Diabetes was not associated with the rate of MMSE decline in nondemented subjects (p = 0.89).
Conclusion:
In individuals with questionable dementia (CDR = 0.5), diabetes is associated with a faster rate of cognitive decline as measured by the MMSE, but not in nondemented (CDR = 0) or frankly demented (CDR > or =1) individuals.
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