Debling Desiree, Amelang Manfred, Hasselbach Petra, Stürmer Til
Department of Psychology, University of Heidelberg, Germany.
J Diabetes Complications. 2006 Jul-Aug;20(4):238-45. doi: 10.1016/j.jdiacomp.2005.06.016.
The aim of this study was to examine the association between diabetes and cognitive function in the elderly.
From January to December 2003, all 740 participants, aged 70 years or more, of an ongoing population-based cohort study were eligible for a telephone interview on cognitive function. Cognitive function was assessed using validated instruments, including the Telephone Interview of Cognitive Status (TICS) and the East Boston Memory Test (EBMT). Information on diabetes was available from prior questionnaires and was validated in 2002. We used multivariable logistic regression to estimate odds ratios (OR) of an impaired cognitive function (below 25th percentile) and their 95% confidence intervals (CI) adjusting for age, gender, smoking, alcohol consumption, body mass index (BMI), physical exercise, educational level, and depressive symptoms.
Out of 473 participants interviewed (64.9%), 66 had diabetes (14.1%). The adjusted OR for diabetes and impaired cognitive function assessed by TICS was 2.3 (95% CI: 1.2-4.3). Diabetes was also associated with performance on delayed recall EBMT (adjusted OR=2.0; 95% CI: 1.0-4.1), but not immediate EBMT recall (adjusted OR=1.0; 95% CI: 0.5-2.1). The association between diabetes and cognitive function was a bit more pronounced in participants in whom diabetes was diagnosed 12 (median) or more years prior (adjusted OR with TICS=2.4; 95% CI: 1.0-5.8) and in those without antidiabetic treatment (age- and sex-adjusted OR=3.4; 95% CI: 1.7-6.5).
Diabetes should be considered to be a risk factor for cognitive impairment in the elderly, which might be attenuated by antidiabetic treatment.
本研究旨在探讨老年人糖尿病与认知功能之间的关联。
2003年1月至12月，一项正在进行的基于人群的队列研究中所有740名年龄在70岁及以上的参与者均有资格接受关于认知功能的电话访谈。认知功能使用经过验证的工具进行评估，包括认知状态电话访谈（TICS）和东波士顿记忆测试（EBMT）。糖尿病信息来自之前的问卷，并于2002年得到验证。我们使用多变量逻辑回归来估计认知功能受损（低于第25百分位数）的比值比（OR）及其95%置信区间（CI），并对年龄、性别、吸烟、饮酒、体重指数（BMI）、体育锻炼、教育水平和抑郁症状进行调整。
在接受访谈的473名参与者（64.9%）中，66人患有糖尿病（14.1%）。通过TICS评估，糖尿病与认知功能受损的调整后OR为2.3（95%CI：1.2 - 4.3）。糖尿病还与EBMT延迟回忆表现相关（调整后OR = 2.0；95%CI：1.0 - 4.1），但与EBMT即时回忆无关（调整后OR = 1.0；95%CI：0.5 - 2.1）。糖尿病与认知功能之间的关联在糖尿病诊断时间为12年（中位数）或更长时间的参与者中更为明显（TICS调整后OR = 2.4；95%CI：1.0 - 5.8），以及在未接受抗糖尿病治疗的参与者中（年龄和性别调整后OR = 3.4；95%CI：1.7 - 6.5）。
糖尿病应被视为老年人认知障碍的一个危险因素，抗糖尿病治疗可能会减轻这种影响。
