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Abstract
Objective: To compare cognitive performance in those with diabetes, impaired glucose tolerance, and normoglycemia in a middle-aged cohort.
Methods: The authors analyzed data from a prospective occupational cohort study begun in 1985–1988 (baseline). Diabetes was classified from oral glucose tolerance tests that were performed in 1992–1993 (phase 3) and 1997–1999 (phase 5) and self reported diagnosis of diabetes from questionnaire at baseline, 1989 (phase 2), phase 3, 1995 (phase 4), and phase 5 of the study. A battery of cognitive tests (memory, Alice Heim 4 [AH 4], Mill Hill vocabulary test, phonemic fluency, and categorical fluency) were measured at phase 5 in 4,020 men and 1,627 women with a mean age of 56 and free of symptoms of stroke.
Results: At phase 5, a total of 208 (5%) men and 101 (6%) women had diabetes while 405 (10%) men and 192 (12%) women had impaired glucose tolerance. Those with diabetes were at increased risk of poor performance in AH 4 compared to those without (men: OR, 2.45; 95% CI, 1.77 to 3.38; women: OR, 1.83; 95% CI, 1.09 to 3.08). These effects were independent of age, social position, vascular problems, and health-related behaviors. Impaired glucose tolerance was not related to any measure of cognition.
Conclusions: Type 2 diabetes is associated with poor performance in some aspects of cognition in middle-aged men and women.
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