Comorbid diabetes and multiple sclerosis negatively affect cognitive functioning in older adults

Multiple sclerosis (MS) and diabetes can cause deficits in processing speed, executive functioning, and learning and memory, although there is limited research on their combined impact. This study aimed to evaluate whether having both conditions had a negative effect on cognitive functioning in older adults.

Persons with MS (n = 108) and healthy controls (HC; n = 114) completed letter fluency, semantic fluency, Trail Making Test (TMT), Symbol Digit Modalities Test (SDMT), and Hopkins Verbal Learning Test-Revised (HVLT-R). Distribution-based z-scores were calculated for each measure, which were used to compute an overall cognition z-score. Using the composite z-score as the outcome and adjusting for demographics, mood, and vascular-related factors, linear regression models were conducted, first with 1) diabetes and 2) MS as the independent variables, and then with 1) diabetes only, 2) MS only, and 3) both diabetes and MS. The latter approach was used to examine the individual measures.

Sixteen persons with MS (14.8 %) and 13 HC (11.4 %) had diabetes. Both diabetes (b = -0.30, p = .022) and MS (b = -0.30, p = .002) were independently associated with overall cognition. Having both conditions had a significant negative effect on overall cognition (b = -0.67, p < .001). The combination of diabetes and MS was associated with reductions in semantic fluency and HVLT-R Total Learning and Delayed Recall.

In older adults, having both diabetes and MS negatively affects cognitive functioning. Clinicians should consider how comorbidities may contribute to greater difficulties in certain cognitive domains in older persons with MS.