Cognitive function in adults with type 2 diabetes and major depression

Division of Geriatric Psychiatry, UCLA Semel Institute & Resnick Neuropsychiatric Hospital, 760 Westwood Plaza, 37-372A, Los Angeles, CA 90024-1759, United States.
Archives of Clinical Neuropsychology (Impact Factor: 1.99). 01/2007; 21(8):787-96. DOI: 10.1016/j.acn.2006.06.014
Source: PubMed


The aim of this study was to identify characteristics of neuropsychological functioning among type 2 diabetic adults with and without major depression. Twenty type 2 diabetics with major depression, 20 non-depressed type 2 diabetics and 34 controls without diabetes or depression were compared. A mixed effects repeated measures analysis of covariance indicated significant differences in overall cognitive functioning between diagnostic groups, specifically depressed diabetics demonstrated greater cognitive dysfunction than controls. Further comparisons indicated that depressed diabetics performed significantly worse than non-depressed diabetics in attention/information processing speed. Relative to controls, depressed diabetics performed significantly worse in attention/information processing speed and executive functioning, while there was a trend for non-depressed diabetics to perform worse in executive functioning. These findings suggest that depression negatively impacts cognitive performance among adults with type 2 diabetes, which may have implications for neural circuitry underlying cognitive and mood changes in diabetic patients.

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    • "Number Sequencing, Matrix Reasoning, Wisconsin Card Sorting Test, Stroop Test, Trail Making Test B, Verbal Fluency Task, and the Ruff Figural Fluency Task (Watari et al., 2006 "
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    ABSTRACT: Objective The purpose of this study was to examine the relationship between verbal learning and memory performance and hippocampal volume in subjects with co-morbid type 2 diabetes and major depression compared with healthy control subjects and subjects with type 2 diabetes alone. Methods Twenty four subjects with type 2 diabetes and 20 subjects with type 2 diabetes and major depression were recruited from endocrinology clinics and were compared with 32 healthy control subjects recruited from the community. Subjects were scanned on a 1.5 T GE scanner, and hippocampal volumes were measured using Freesurfer. The California Verbal Learning Test assessed learning and memory. Significant predictors of verbal learning performance (e.g., age, gender, education, blood pressure, stroke risk, hemoglobin A1c, and hippocampal volume) were determined using a stepwise linear regression. ResultsSubjects with diabetes and depression had significantly worse performance on verbal list learning compared with healthy control subjects. Hippocampal volume was a strong predictor of performance in healthy control subjects, and age and hippocampal volume were strong predictors in subjects with type 2 diabetes alone. Age alone was a significant predictor of verbal learning performance in subjects with diabetes and depression. Conclusions The relationship between hippocampal volume and performance on the California Verbal Learning Test is decoupled in subjects with type 2 diabetes and major depression and this decoupling may contribute to poor verbal learning and memory performance in this study population. Copyright (c) 2014 John Wiley & Sons, Ltd.
    International Journal of Geriatric Psychiatry 04/2015; 30(4). DOI:10.1002/gps.4149 · 2.87 Impact Factor
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    • "Diabetic patients show impaired cognitive function, increased behavioral symptoms, and decreased activity of daily living (Table 2). Diabetic patients show impairment of memory (25), attention (26, 27), executive function (28, 29), information processing (28, 29), planning (11), visuospatial construction (11), and visual memory (11, 21). Diabetic patients are reported to have impaired memory retrieval rather than encoding (25). "
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    ABSTRACT: Emerging evidence suggests that diabetes affects cognitive function and increases the incidence of dementia. However, the mechanisms by which diabetes modifies cognitive function still remains unclear. Morphologically, diabetes is associated with neuronal loss in the frontal and temporal lobes including the hippocampus, and aberrant functional connectivity of the posterior cingulate cortex and medial frontal/temporal gyrus. Clinically, diabetic patients show decreased executive function, information processing, planning, visuospatial construction, and visual memory. Therefore, in comparison with the characteristics of AD brain structure and cognition, diabetes seems to affect cognitive function through not only simple AD pathological feature-dependent mechanisms but also independent mechanisms. As an Aβ/tau-independent mechanism, diabetes compromises cerebrovascular function, increases subcortical infarction, and might alter the blood-brain barrier. Diabetes also affects glucose metabolism, insulin signaling, and mitochondrial function in the brain. Diabetes also modifies metabolism of Aβ and tau and causes Aβ/tau-dependent pathological changes. Moreover, there is evidence that suggests an interaction between Aβ/tau-dependent and independent mechanisms. Therefore, diabetes modifies cognitive function through Aβ/tau-dependent and independent mechanisms. Interaction between these two mechanisms forms a vicious cycle.
    Frontiers in Endocrinology 09/2014; 5:143. DOI:10.3389/fendo.2014.00143
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    • "In other word the performance of diabetic group was lower than the other two groups. Wateriet et al. [26] in their studies report that there was a significant difference between diabetic and control group in their information processing and executive functions, which is similar to the result of this study. This finding is concordant with the reports of Berg et al. [16] and Elderen et al. [2]. "
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    ABSTRACT: Diabetes is associated with cognitive decline or dementia. The purpose of this study was to assess the executive functions and information processing in patients with type 2diabetes in comparison to pre-diabetic patients and normal subjects in Endocrine and Metabolism Research Center of Isfahan City from April to July 2011. The sample consisted of 32 patients with type 2 diabetes, 28 pre-diabetic patients and 30 healthy individuals. Executive functions were assessed by Wisconsin Card Sorting Test (WCST). Information processing was assessed by Paced Auditory Serial Addition Test (PASAT) and sub tests of Wechsler Adult Intelligence Scale-Revised (WAIS-R). There was a significant difference among 3 groups, after the variables of age, sex and academic status were controlled (p <= 0.001). The pairwise comparisons of executive functions among three groups suggest a significant difference between diabetic and normal groups in WCST (perseveration) p = 0.018, and significant difference between diabetic and pre-diabetic patient in WCST (perseveration) p = 0.019. But there was no difference between three groups in WCST (category) and WCST (conceptual responses).The pairwise comparisons of information processing among three groups, suggest a significant difference between diabetic and normal groups in PASAT3". PASAT2", and Symbol coding (P = 0.003, P = 0.009, and P = 0.001, respectively).There was a significant correlation between demographic variable (FBS, HbA1c) and Symbol coding p = 0.05, p = 0.01 respectively) and significant correlation between (cholesterol) and WCST (conceptual responses) p = 0.05. The other variables were not correlated. There were significant differences in executive function and information processing in patients with type2 diabetic and normal individuals. Thus, monitoring neuropsychological status besides controlling levels of blood sugar in these patients is important.
    Journal of Diabetes and Metabolic Disorders 02/2014; 13(1):27. DOI:10.1186/2251-6581-13-27
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