The Association Between Diabetes Duration and Domain-Specific Cognitive Impairment: A Population-Based Study

Article type: Research Article

Authors: Tang, Xingyao^{a; 1} | Wang, Ying^{b; 1} | Simó, Rafael^{c; d} | Stehouwer, Coen D.A.^e | Zhou, Jian-Bo^{b; *}

Affiliations: [a] Beijing Tongren Hospital, Capital Medical University, Beijing, China | [b] Endocrinology and Metabolism Department, Beijing Tongren Hospital, Capital Medical University, Beijing, China | [c] Endocrinology and Nutrition Department, Hospital Universitari Vall d’Hebron, Diabetes and Metabolism Research Unit, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d’Hebron, Barcelona, Spain | [d] Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain | [e] Department of Internal Medicine and CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands

Correspondence: [*] Correspondence to: Jian-Bo Zhou, Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, No 1. Dongjiaomingxiang, Dongcheng District, Beijing, China, 100730. E-mail: jbzhou@ccmu.edu.cn

Note: [1] These authors contributed equally to this work.

Abstract: Background:Diabetes is a risk factor for cognitive impairment, and disease duration is associated with geriatric decline and functional disabilities. Objective:This study aimed to examine the association of diabetes duration with domain-specific cognitive impairment in elderly. Methods:A total of 3,142 participants from the National Health and Nutrition Examination Survey (NHANES) from the period between 2011 and 2014 were included. We assessed cognitive function using the Digit Symbol Substitution Test (DSST), the CERAD Word Learning (CERAD-WL) test, the CERAD Delayed Recall (CERAD-DR) test and animal fluency (AF) test. Results:After adjusting for age, sex, race/ethnicity, education level, and annual household income, we found that diabetes with a duration longer than 20 years were at 3.32-fold increased risk of DSST impairment (OR = 3.32, 95% CI: 1.95 to 5.67), 1.72-fold increased risk of CERAD-WL impairment (OR = 1.72, 95% CI: 1.13 to 2.62), and 1.76-fold increased risk of AF impairment (OR = 1.76, 95% CI: 1.23 to 2.53), compared with those with no diabetes. Associations were generally stronger in women than in men. Participants with diabetes, who were diagnosed at 50–59 years old were at increased risk of DSST impairment, CERAD-WL impairment, CERAD-DR impairment, and AF impairment per 5 years longer duration of diabetes. Conclusion:Longer diabetes duration was associated with the increased risk of cognitive impairment, especially in processing speed and attention. The presence of chronic kidney disease was associated with the increased risk of DSST impairment.

Keywords: Age of onset, cognitive impairment, diabetes duration

DOI: 10.3233/JAD-220972

Journal: Journal of Alzheimer's Disease, vol. 91, no. 4, pp. 1435-1446, 2023