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(Stroke. 2009;40:S53.)
© 2009 American Heart Association, Inc.

Vascular Cognitive Impairment

Diabetes: Vascular or Neurodegenerative

An Epidemiologic Perspective

From the Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, Md.

Correspondence to Lenore J. Launer, MD, Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, MD 20892. E-mail launerl@nia.nih.gov.

Key Words: diabetes • vascular dementia

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Type 2 diabetes and cognitive impairment are 2 of the most common chronic conditions found in persons 60 years and older. After that age, approximately 18% to 20% of older persons have diabetes,¹ approximately 19% suffer from mild cognitive impairment in multiple domains,² and approximately 6% of community-dwelling individuals have some dementia.³ The prevalence of mild cognitive impairment and dementia increases with age as does the prevalence of diabetes; there is also an alarming trend toward a younger age of diabetes onset.⁴ Several lines of investigation suggest a link among diabetes, cognitive impairment, and dementia, described briefly subsequently. Thus, the age-related trends in diabetes and cognitive disorders indicate a further increase in the number of persons with mild cognitive impairment and dementia, beyond the increase that is expected as the population ages.

	What Is the Evidence Linking Diabetes to Late-Age Cognitive Disorders?

 
Clinical studies have shown impaired neuropsychological functioning in patients with diabetes.⁵ Compared with community-dwelling normoglycemic persons, those with diabetes have a higher prevalence of global cognitive impairment⁶ and a higher incidence of cognitive decline.⁷ Population-based studies have also shown that diabetes is a risk factor for Alzheimer disease (AD),^8–11 the most common form of dementia.

The association of diabetes to cognitive disorders may be moderated by a spectrum of factors that range from healthcare access to genetic susceptibility. For example, data from several studies suggest those with diabetes and who are apolipoprotein E 4 allele (a genetic susceptibility risk factor for AD) carriers are at higher risk for a cognitive disorder than those with no diabetes and no . . . [Full Text of this Article]

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