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, MD12,
- Linda J. Romero, MD23,
- Asenath LaRue, PHD24,
- C. Lillian Yau, MS2,
- David S. Schade, MD1,
- Kathleen M. Koehler, PHD2,
- Richard N. Baumgartner, PHD12 and
- Phillip J. Garry, PHD25
- 1Department of Internal Medicine, the
- 2Clinical Nutrition Program, and the Departments of
- 3Family and Community Medicine
- 4Psychiatry, and
- 5Pathology, 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.
- 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
Address correspondence and reprint requests to Robert D. Lindeman, MD, Clinical Nutrition Program, Surge Building Room #215, 2701 Frontier Ave., N.E., Albuquerque, NM 87131-5666. E-mail:.
Received for publication 17 July 2000 and accepted in revised form 16 May 2001.
Robert D. Lindeman owns stock in Merck & Co. as part of a personal, diversified portfolio.
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