Association of Diabetes Mellitus and Mild Cognitive Impairment in Middle-Aged Men and Women

Article type: Research Article

Authors: Winkler, Angela^{a; *} | Dlugaj, Martha^a | Weimar, Christian^a | Jöckel, Karl-Heinz^b | Erbel, Raimund^c | Dragano, Nico^d | Moebus, Susanne^b | on behalf of the Heinz Nixdorf Recall Study Investigative Group

Affiliations: [a] Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany | [b] Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany | [c] Clinic of Cardiology, West German Heart Centre, University Hospital of Essen, University Duisburg-Essen, Essen, Germany | [d] Institute for Medical Sociology, Centre for Healthy and Society, University of Düsseldorf, Düsseldorf, Germany

Correspondence: [*] Correspondence to: Angela Winkler, MA, Department of Neurology, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany. Tel.: +49 201 7232264; Fax: +49 201 7235901; E-mail: [email protected].

Abstract: Background:Several studies reported on the association of type 2 diabetes (T2DM) with dementia. Studies on the association of T2DM and mild cognitive impairment (MCI) are rare. Objective:To evaluate the gender-specific association of T2DM with MCI and MCI subtypes (amnestic MCI (aMCI) and non-amnestic MCI (naMCI)) in a middle-aged (50–65 years) and old-aged (66–80 years) population-based study sample. Methods:We compared 560 participants with MCI (aMCI n = 289, naMCI n = 271) with 1,376 cognitively normal participants from the Heinz Nixdorf Recall study. Diabetic status was based on self-reported physician’s diagnosis or treatment with anti-diabetic medication. We performed group comparisons regarding all cognitive subtests for participants with and without T2DM. Logistic regression models (adjusted for age, education, cardiovascular risk factors, and depression) were used to determine the association of T2DM with MCI and MCI subtypes. Results:In the middle-aged group, fully adjusted models showed an association (odds ratio, 95% CI) of T2DM with MCI that was more pronounced in men (total: 2.03, 1.23–3.36, men: 2.16, 1.12–4.14, women 1.69, 0.73–3.89). T2DM was associated with MCI subtypes (aMCI: 2.01, 1.08–3.73; naMCI: 2.06, 1.06–3.98), whereas, the association was stronger with naMCI in men (2.61, 1.14–5.98) and with aMCI in women (3.02, 1.27–7.17). We found no total or gender-specific association of T2DM with MCI or MCI subtypes in the old-aged group. Conclusions:Our data show that T2DM is associated with MCI and MCI subtypes in middle-aged, but not in old-aged participants. Furthermore, the results indicate a gender-specific vulnerability of T2DM on cognition, especially in MCI subtypes.

Keywords: Aging, gender, mild cognitive impairment, population-based studies, type 2 diabetes mellitus

DOI: 10.3233/JAD-140696

Journal: Journal of Alzheimer's Disease, vol. 42, no. 4, pp. 1269-1277, 2014