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Cognitive disorders often missed in adults with diabetes
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Adults with diabetes — even those treated in a specialized diabetes clinic — often remain undiagnosed for cognitive disorders, including mild cognitive impairment and dementia, study data show.
Corbett Schimming, MD, of James J. Peters VA Medical Center in Bronx, New York, and colleagues evaluated 30 adults with diabetes from the Mount Sinai Diabetes Center, as well as data from the Mount Sinai Alzheimer’s Disease Research Center on 189 adults without diabetes or cognitive impairment and 98 adults without diabetes and a diagnosis of amnestic mild cognitive impairment. Researchers sought to determine the frequency of cognitive disorders and patterns of deficits among patients in a specialized diabetes clinic.
The diabetes group was younger (P < .0001) and less educated (P < .0001) and included more Hispanic participants (P < .0001) compared with the other two groups.
In all participants, HbA1c ranged from 5.8% to 14.3%, with a mean of 8.2%. Cognitive disorders were present in 40% of all participants; 10% received a diagnosis of dementia and 30% received a diagnosis of mild cognitive impairment.
Compared with participants without diabetes or cognitive impairment, participants with diabetes scored worse on the Mini-Mental State Examination (P = .0132), list generation (P = .019), Trail Making Test, Parts A (P < .001) and B (P < .0001), and the Digit Symbol test (P < .0001). Participants with diabetes scored better on tasks of immediate recall (P = .0048) and delayed recall (P = .0003) compared with participants without diabetes but with cognitive impairment.
“Despite these findings and their implications for management, diabetic patients’ cognitive problems remain relatively underappreciated by clinicians and patients,” the researchers wrote. “The data suggest that it is critically important to study the cognitive trajectory of these individuals longitudinally to better understand the relationship between diabetes and dementia. In the short term, it would be clinically useful for clinicians to build in baseline and ongoing cognitive assessment of their patients, in addition to standard diabetes care.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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