Diabetes, impaired fasting glucose, and cognitive trajectories: a multi-cohort study
Lo, J. W.; Crawford, J. D.; Samaras, K.; Lipton, R. B.; Katz, M. J.; Derby, C. A.; Preux, P.-M.; Guerchet, M.; d'Orsi, E.; Quialheiro, A.; Rech, C. R.; Ritchie, K.; Rolandi, E.; Davin, A.; Rossi, M.; Shahar, S.; Rajab, N.; Rivan, N. F. M.; Ganguli, M.; Jacobsen, E.; Snitz, B. E.; Brodaty, H.; Chen, Y.-C.; Chen, J.-H.; Lennon, M.; Lipnicki, D. M.; Sachdev, P. S.
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INTRODUCTION: Cognitive trajectories may clarify how type 2 diabetes (T2D) and impaired fasting glucose (IFG) relate to dementia risk, but longitudinal associations remain unclear, particularly in the context of stroke. METHODS: Data from 5,631 dementia- and stroke-free older adults (mean age 75 years) from 7 international population-based cohorts were analyzed. Linear mixed-effects models estimated cognitive trajectories during stroke-free and post-stroke follow-up. Glucose status was defined by fasting glucose and prior T2D diagnosis. RESULTS: Over 6.6 years of follow-up (4.5% with incident stroke), T2D was associated with lower baseline cognitive performance compared with normal fasting glucose (-0.14 SD, 95% CI -0.21 to -0.07), but not with faster cognitive decline during stroke-free or post-stroke follow-up. IFG was not associated with lower cognitive performance or faster decline. DISCUSSION: In older adults, T2D was associated with persistently lower cognitive performance but not faster decline, suggesting adverse cognitive effects may be established before late life.
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