Type 2 Diabetes and Cognitive Function in Community-Dwelling Elderly Women

OBJECTIVE: To examine the relationship of type 2 diabetes to cognitive function in community-dwelling women. RESEARCH DESIGN AND METHODS: From 1995 to 1999, we administered four tests of cognitive function (Telephone Interview of Cognitive Status TICS, immediate and delayed recall of the East Boston Memory Test, and verbal fluency) by telephone to 2,374 participants (70-78 years of age) of the Nurses' Health Study. Information on diabetes was collected biennially beginning in 1976; 82 women reported type 2 diabetes before their cognitive testing. We used linear and logistic regression models to calculate multivariate-adjusted mean differences in scores and relative risks of a low score (bottom 10% of the distribution) for diabetic women compared with nondiabetic women. RESULTS: After multivariate adjustment, women with type 2 diabetes scored lower on all our cognitive tests than women without diabetes. On the general test of cognition (TICS), the mean difference in score between women with and without diabetes was -0.60 (95% CI -1.18 to -0.03, P = 0.04) and the relative risk of a low TICS score was 1.98 (95% CI 1.06 to 3.69). On a global score combining results of the four tests, the mean for diabetic women was lower than that among women without diabetes (adjusted difference in score -0.73, 95% CI -1.42 to -0.04, P = 0.04), and the relative risk of a low global score was 2.16 (95% CI 1.10 to 4.21). Relative to women without diabetes, longer duration of diabetes was associated with lower scores. Few diabetic women were pharmacologically treated (n = 31), but those taking medication had scores similar to those of women without diabetes. CONCLUSIONS: In these women, diabetes was related to lower scores on several aspects of cognitive function. Longer duration of diabetes may be associated with poorer scores, but hypoglycemic therapy may ameliorate scores.