Diabetes, Cognitive Function and Mortality Risk Among Older Hispanics

Background: Diabetes is a leading cause of death globally and is strongly associated with aging-related conditions, such as cognitive decline. Both diabetes and cognitive impairment share overlapping biological mechanisms, including vascular damage and insulin resistance. While each condition independently affects health outcomes, the impact of their coexistence on mortality risk among older Hispanic adults remains understudied. This study aimed to examine the impact of the combination of diabetes and low cognitive performance on mortality risk among this marginalized population. Methods: Data were drawn from 636 Hispanic adults aged 60 years and older who participated in NHANES 1999–2002, with mortality follow-up through 2019. Cox proportional hazards models were used to estimate hazard ratios (HRs) for all-cause mortality, adjusting for sociodemographic and health-related variables. Results: Among participants, 23.3% had diabetes, and 54.9% had low cognitive performance. The combination of diabetes and low cognitive performance was associated with a significantly elevated risk of all-cause mortality (HR = 2.36; 95% CI: 1.70–3.28). No statistically significant increase in mortality risk was observed for either condition alone (i.e. diabetes or cognitive impairment). Conclusions: Coexisting diabetes and cognitive impairment in older Hispanic adults were associated with more than a twofold increase in mortality risk. These findings underscore the need for culturally appropriate, interdisciplinary strategies to address the dual burden of diabetes and cognitive decline in aging minority populations.