Association of Duration and Severity of Diabetes Mellitus With Mild Cognitive Impairment

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Abstract
Mild cognitive impairment (MCI) is a transitional stage between normal cognitive aging and dementia.1 In the absence of curative treatments for dementia, identification of subjects at increased risk of dementia and modifiable risk factors may allow interventions that prevent progression from preclinical (MCI) to clinical disease (dementia). Findings from several studies have suggested an association between diabetes mellitus (DM) and cognitive impairment,2-4 rapid decline in cognitive function,5,6 and dementia.7-9 In addition, DM has been associated with increased deposition and decreased clearance of amyloid β.10-12 Poor glycemic control and long-term episodes of hypoglycemia or hyperglycemia may lead to microangiopathy, neuronal loss, and cognitive impairment.13 Finally, DM is associated with increased cardiovascular risk and with macrovascular and microvascular cerebral disease,14 all of which may independently increase the risk of cognitive impairment. However, some studies15-17 have not confirmed the association.