Diabetes Mellitus and Mild Cognitive Impairment: Higher Risk in Middle Age?

2 September 2014

Essen, Germany – In a large population-based study of randomly selected participants in Germany, researchers found that mild cognitive impairment (MCI) occurred twice more often in individuals diagnosed with diabetes mellitus type 2. Interestingly, this strong association was only observed in middle-aged participants (50-65 years), whereas in older participants (66-80 years) the association vanished. This study is published in the Journal of Alzheimer’s Disease.

The concept of MCI describes an intermediate state between normal cognitive aging and dementia. Although people with MCI have a higher dementia risk, very few actually develop dementia. In fact, many persons with MCI convert back to a cognitively normal state. This transitional – and therefore possibly modifiable – characteristic makes the concept of MCI a promising approach in the development of prevention strategies.

What criteria determine MCI? The following four criteria must be met for a diagnosis of MCI: First, participants have a subjective impression of a declined cognitive performance over the last two years. Second, this subjective impression is validated in using objective measures (cognitive test battery). Third, participants are capable of handling activities of daily living. Fourth, a diagnosis of dementia is ruled out.

The concept of MCI distinguishes between two subtypes depending on the affected cognitive domain: participants with impairment in the memory domain are categorized as amnestic MCI and those with deficits in non-memory domains are categorized as non-amnestic MCI.

The Heinz Nixdorf Recall (Risk Factors, Evaluation of Coronary Calcium and Lifestyle) study is an observational, population-based, prospective study that examined 4,814 participants (50% men) between 2000 and 2003 in the metropolitan Ruhr area in Germany. After five years a second examination was conducted with 90% of the participants taking part.

For this analysis, 560 participants diagnosed with MCI were compared with 1376 cognitively normal participants. Of participants with MCI, 289 had amnestic MCI and 271 had non-amnestic MCI.

Interestingly, diabetes mellitus type 2 was strongly associated with MCI as well as MCI subtypes, but only in the middle-aged group. Examination of differences by gender revealed a stronger association of diabetes with amnestic MCI in middle-aged women and by contrast a stronger association with non-amnestic MCI in middle-aged men.

These results suggest that middle-aged individuals with diabetes mellitus type 2 are particularly vulnerable to MCI, with gender specific effects on subtypes of MCI. This underlines the importance of high quality treatment of diabetes especially in middle age, not only because of cardiovascular damage, but also because it might help to prevent or delay cognitive decline.

# # #

NOTES FOR EDITORS

Association of diabetes mellitus and mild cognitive impairment in middle-aged men and women. Angela Winkler, Martha Dlugaj, Christian Weimar, Karl-Heinz Jöckel, Raimund Erbel, Nico Dragano, Susanne Moebus, on behalf the Heinz Nixdorf Recall Study Investigative Group. Journal of Alzheimer’s Disease, Volume 42/4 (October 2014): DOI: 10.3233/JAD-140696.

Full text of the article is available to credentialed journalists upon request. Contact Astrid Engelen, IOS Press, at +31 20 688 3355, a.engelen@iospress.nl to obtain a copy or additional information. Reporters who wish to speak to the authors should contact angela.winkler@uk-essen.de.

ABOUT THE JOURNAL OF ALZHEIMER’S DISEASE (JAD)

The Journal of Alzheimer's Disease (http://www.j-alz.com) is an international multidisciplinary journal to facilitate progress in understanding the etiology, pathogenesis, epidemiology, genetics, behavior, treatment and psychology of Alzheimer's disease. The journal publishes research reports, reviews, short communications, book reviews, and letters-to-the-editor. Groundbreaking research that has appeared in the journal includes novel therapeutic targets, mechanisms of disease and clinical trial outcomes. The Journal of Alzheimer's Disease has an Impact Factor of 3.612 according to Thomson Reuters' 2013 Journal Citation Reports. It is ranked #22 on the Index Copernicus Top 100 Journal List. The Journal is published by IOS Press (www.iospress.com).

ABOUT IOS PRESS

Commencing its publishing activities in 1987, IOS Press (www.iospress.nl) serves the information needs of scientific and medical communities worldwide. IOS Press now (co-)publishes over 100 international journals and about 130 book titles each year on subjects ranging from computer sciences and mathematics to medicine and the natural sciences.

IOS Press continues its rapid growth, embracing new technologies for the timely dissemination of information. All journals are available electronically and an e-book platform was launched in 2005.

Headquartered in Amsterdam with satellite offices in the USA, Germany, India and China, IOS Press has established several strategic co-publishing initiatives. Notable acquisitions included Delft University Press in 2005 and Millpress Science Publishers in 2008.

Contacts:

George Perry, PhD

Editor-in-Chief, Journal of Alzheimer's Disease

Dean and Professor of Biology, The University of Texas at San Antonio

Tel: +1 210 458 4450

Fax:+1 210 458 4445

Email: george.perry@utsa.edu

Astrid Engelen

IOS Press

Tel: +31 20 688 3355

Fax: +31 20 687 0019

Email: a.engelen@iospress.nl