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Diabetes Care 24:1567-1572, 2001
© 2001 by the American Diabetes Association, Inc.

Epidemiology/Health Services/Psychosocial Research
Original Article

A Biethnic Community Survey of Cognition in Participants With Type 2 Diabetes, Impaired Glucose Tolerance, and Normal Glucose Tolerance

The New Mexico Elder Health Survey

Robert D. Lindeman, MD1,2, Linda J. Romero, MD2,3, Asenath LaRue, PHD2,4, C. Lillian Yau, MS2, David S. Schade, MD1, Kathleen M. Koehler, PHD2, Richard N. Baumgartner, PHD1,2 and Phillip J. Garry, PHD2,5

1 Department of Internal Medicine, the
2 Clinical Nutrition Program, and the Departments of
3 Family and Community Medicine
4 Psychiatry, and
5 Pathology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico

OBJECTIVE—To determine whether elderly individuals with type 2 diabetes or impaired glucose tolerance are at increased risk for cognitive impairment compared with individuals with normal glucose tolerance.

RESEARCH DESIGN AND METHODS—Elderly Hispanic individuals (n = 414) and non-Hispanic white individuals (n = 469) aged >=65 years, randomly selected from the Medicare rolls of Bernalillo County (Albuquerque), NM, were recruited for an interview/examination that included an evaluation of glucose tolerance. Information on nine tests of cognitive function and two measures of depression allowed comparisons between diabetic status and these functions. Comparisons also were made between glycosolated hemoglobin concentrations and these cognitive tests in the 188 participants with diabetes.

RESULTS—None of the mean scores on the tests of cognitive function was significantly lower in the participants with diabetes compared with those participants with normal glucose tolerance after adjustments for ethnicity, sex, age, level of education, and presence of depression, with or without elimination of those with dementia (Mini-Mental State Exam <18). Interestingly, participants with impaired glucose tolerance tended to score higher than those with normal glucose tolerance. No significant associations were found between glycosolated hemoglobin concentrations and cognitive test scores in participants with diabetes.

CONCLUSIONS—We could not show any increased risk for cognitive impairment in participants with diabetes compared with those with normal glucose tolerance after adjustments for ethnicity, sex, age, education, and presence of depression, before or after elimination of dementia in this random sample from a biethnic population of predominantly community-dwelling elders.

Abbreviations: GDS, Geriatric Depression Scale • GHb, glycosolated hemoglobin • GLM, generalized linear regression model • IGT, impaired glucose tolerance • NGT, normal glucose tolerance • MMSE, Mini-Mental State Exam • NHW, non-Hispanic white


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