Diabetes Mellitus and Cognitive Decline – Prevention Should Not Be Delayed!

  • Alan J. Sinclair
  • B. Vellas


  1. 1.
    Ott A, Stolk RP, van Harskamp F, Pols HA, Hofman A, Breteler MM. Diabetes mellitus and the risk of dementia: the Rotterdam Study. Neurology 1999; 53:1937–1942CrossRefPubMedGoogle Scholar
  2. 2.
    Peila R, Rodriguez BL, Launer LI. Type 2 diabetes, APOE gene, and the risk for dementia and related pathologies: the Honolulu-Asia Aging Study. Diabetes 2002; 51:1256–1262CrossRefPubMedGoogle Scholar
  3. 3.
    Ryan CM. Diabetes, aging, and cognitive decline. Neurobiol Aging 2005; 26 (Suppl.1): 21–25CrossRefPubMedGoogle Scholar
  4. 4.
    Hassing LB, Hofer SM, Nilsson SE et al. Comorbid type 2 diabetes mellitus and hypertension exacerbates cognitive decline: evidence from a longitudinal study. Age and Ageing 2004; 33 (4): 355–61CrossRefPubMedGoogle Scholar
  5. 5.
    Xu W, Caracciolo B, Wang H-X et al. Accelerated progression from mild cognitive impairment to dementia in people with diabetes. Diabetes 2010; 59:2928–2935CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Strachan MW, Deary IJ, Ewing FM, Frier BM. Is type II diabetes associated with an increased risk of cognitive dysfunction? A critical review of published studies. Diabetes Care 1997; 20 (3):438–45CrossRefPubMedGoogle Scholar
  7. 7.
    Cheng G, Huang C, Deng H, Wang H. Diabetes as a risk factor for dementia and mild cognitive impairment: a meta-analysis of longitudinal studies. Intern Med J 2012; 42: 484–491CrossRefPubMedGoogle Scholar
  8. 8.
    Li J, Shao YH, Gong YP, Lu YH, Liu Y, Li CL. Diabetes mellitus and dementia–a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci 2014; 18:1778–1789PubMedGoogle Scholar
  9. 9.
    Cukierman T, Gerstein HC, Williamson JD. Cognitive decline and dementia in diabetes–systematic overview of prospective observational studies. Diabetologia 2005; 48:2460–2469CrossRefPubMedGoogle Scholar
  10. 10.
    Chatterjee S, Peters SAE, Woodward M et al. Type 2 diabetes as a risk factor for dementia in women compared with men: a pooled analysis of 2.3 million people comprising more than 100,000 cases of dementia. Diabetes Care 2016; 39:300–307PubMedGoogle Scholar
  11. 11.
    Ravona-Springer R, Heymann A, Schmeidler J et al. Trajectories in glycemic control over time are associated with cognitive performance in elderly subjects with type 2 diabetes. Plos One 2014; 9(6): e97384CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Cui X, Amir A, Manor BD et al. Multi-scale glycemic variability: a link to gray matter atrophy and cognitive decline in type 2 diabetes. Plos One 2014; 9(1): e86284CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Yaffe K, Falvey C, Hamilton N. Diabetes, glucose control, and 9-year cognitive decline among older adults without dementia. Arch Neurol. 2012 Sep;69(9):1170–5CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Exalto LG, Biessels GJ, Karter AJ et al. Risk score for prediction of 10 year dementia risk in individuals with type 2 diabetes: a cohort study. Lancet Diabetes Endocrinol 2013: 1(3): 183–190CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Munshi MN. Cognitive dysfunction in older adults with diabetes: what a clinician needs to know. Diabetes Care 2017; 40: 461–467CrossRefPubMedGoogle Scholar
  16. 16.
    Brands AM, Biessels GJ, de Haan et al. The effects of type 1 diabetes on cognitive performance: a meta-analysis. Diabetes Care 2005; 8: 726–735CrossRefGoogle Scholar
  17. 17.
    T Li W, Huang E, Gao S. Type 1 Diabetes Mellitus and Cognitive Impairments: A Systematic Review. J Alzheimers Dis. 2017;57(1):29–36.CrossRefGoogle Scholar
  18. 18.
    Kodl CT, Seaquist ER. Cognitive dysfunction and diabetes mellitus. Endocrine Rev 2008; 29(4): 494–511CrossRefGoogle Scholar
  19. 19.
    Yaffe K, Blackwell T, Whitmer RA et al. Glycosylated haemoglobin level and development of mild cognitive impairment or dementia in older women. J Nutr Health Aging 2006; 10: 293–5PubMedGoogle Scholar
  20. 20.
    Lehtisalo J, Lindstrom J, Ngandu T et al. Diabetes, glycaemia, and cognition–a secondary analysis of the Finnish Diabetes Prevention Study. Diabetes Metab Res rev 2016; 32(1): 102–110CrossRefPubMedGoogle Scholar
  21. 21.
    Sridhar GR, Lakshmi G, Nagamani G. Emerging links between type 2 diabetes and Alzheimer’s disease. World J Diabetes 2015 6(5): 744–751CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Rao AA, Sridhar GR, Das UN. Elevated butyrylcholinesterase and acetylcholinesterase may predict the development of type 2 diabetes mellitus and Alzheimer’s Disease. Med Hypotheses 2007; 69:1272–1276CrossRefPubMedGoogle Scholar
  23. 23.
    Li W, Huang E. An Update on Type 2 Diabetes Mellitus as a Risk Factor for Dementia. J Alzheimers Dis. 2016 May 3;53(2):393–402CrossRefPubMedGoogle Scholar
  24. 24.
    Wrighten SA, Piroli GG, Grillo CA, Reagan LP. A look inside the diabetic brain: contributors to diabetes-induced brain aging. Biochim Biophys Acta 2009; 1792 (5): 444–453CrossRefPubMedGoogle Scholar
  25. 25.
    Zhou X, Zhang J, Chen Y et al. Aggravated cognitive and brain functional impairment in mild cognitive impairment patients with type 2 diabetes: a resting state functional MRI study. J Alzheimers Dis 2014; 41(3): 925–35CrossRefPubMedGoogle Scholar
  26. 26.
    Cui Y, Jiao Y, Chen YC et al. Altered spontaneous brain activity in type 2 diabetes: a resting-state functional MRI study. Diabetes 2014; 63(2): 749–60CrossRefPubMedGoogle Scholar
  27. 27.
    Prince M1, Bryce R, Albanese E, Wimo A, Ribeiro W, Ferri CP. The global prevalence of dementia: a systematic review and metaanalysis. Alzheimers Dement. 2013 Jan;9(1):63–75.e2. doi: 10.1016/j.jalz.2012.11.007.CrossRefPubMedGoogle Scholar
  28. 28.
    World Health Organisation. Diabetes: Global fact sheet. Available at:
  29. 29.
    Sinclair AJ, Hillson R, Bayer AJ; National Expert Working Group. Diabetes and dementia in older people: a Best Clinical Practice Statement by a multidisciplinary National Expert Working Group. Diabet Med 2014; 31(9): 1024–31CrossRefPubMedGoogle Scholar
  30. 30.
    Dunning T, Sinclair A, Colagiuri S. New IDF Guideline for managing type diabetes in older people. Diabetes Res Clin Pract 2014; 103(3): 538–40CrossRefPubMedGoogle Scholar
  31. 31.
    Mehta HB, Mehta V, Goodwin JS. Association of hypoglycaemia with subsequent dementia in older patients with type 2 diabetes mellitus. J Gerontol A Biol Sci Med Sci 2017; 7298): 1110–1116Google Scholar
  32. 32.
    Sullivan MD, Katon WJ, Lovato LC et al. Association of depression with accelerated cognitive decline among patients with type 2 diabetes in the ACCORD-MIND trial. JAMA Psychiatry 2012; 70(10)1041–7CrossRefGoogle Scholar
  33. 33.
    Katon W, Lyles CR, Parker MM, Karter AJ, Huang ES, Whitmer RA. Association of depression with increased risk of dementia in patients with type 2 diabetes: the Diabetes and Aging Study. Arch Gen Psychiatry 2012; 69(4): 410–17CrossRefPubMedGoogle Scholar
  34. 34.
    Abdelhafiz AH, McNicholas E, Sinclair AJ. Hypoglycemia, frailty and dementia in older people with diabetes: reciprocal relations and clinical implications. J Diabetes Complications 2016; 30(8): 1548–1554CrossRefPubMedGoogle Scholar
  35. 35.
    Sinclair AJ, Girling AJ, Bayer AJ. Cognitive dysfunction in older subjects with diabetes mellitus: impact on diabetes self-management and use of care services. All Wales Research into Elderly (AWARE) Study. Diabetes Res Clin Pract 2000; 50: 203–212CrossRefPubMedGoogle Scholar
  36. 36.
    Bunn F, Goodman C, Jones PR et al. What works for whom in the management of diabetes in people living with dementia: a realist review. BMC Med 2017; 15(1): 141CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    García-Casares N, García-Arnés JA, Gómez-Huelgas R, Valdivielso-Felices P, García-Arias C, González-Santos P. Glucagon-like peptide-1 (GLP-1) mimetics: a new treatment for Alzheimer’s disease? Rev Neurol. 2014 Dec 1;59(11):517–24.PubMedGoogle Scholar
  38. 38.
    Liu J, Wang LN, Jia JP. Peroxisome proliferator-activated receptor-gamma agonists for Alzheimer’s disease and amnestic mild cognitive impairment: a systematic review and meta-analysis. Drugs Aging. 2015 Jan;32(1):57–65CrossRefPubMedGoogle Scholar
  39. 39.
    Galimberti D1, Scarpini E1. Pioglitazone for the treatment of Alzheimer’s disease. Expert Opin Investig Drugs. 2017 Jan;26(1):97–101.. Epub 2016 Dec4.CrossRefPubMedGoogle Scholar
  40. 40.
    Roses AD, Saunders AM, Lutz MW, Zhang N, Hariri AR, Asin KE, Crenshaw DG, Budur K, Burns DK, Brannan SK. New applications of disease genetics and pharmacogenetics to drug development. Curr Opin Pharmacol. 2014 Feb;14:81–9CrossRefPubMedGoogle Scholar

Copyright information

© Serdi and Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Alan J. Sinclair
    • 1
    • 3
  • B. Vellas
    • 2
  1. 1.Foundation for Diabetes Research in Older PeopleDiabetes Frail LtdBedfordshireUK
  2. 2.Gérontopôle, Centre Hospitalier Universitaire de ToulouseToulouseFrance
  3. 3.Clinical Trials CentreMedici Medical PracticeLutonUK

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