University of Oulu

Papunen, S., Mustakallio-Könönen, A., Auvinen, J., Timonen, M., Keinänen-Kiukaanniemi, S., & Sebert, S. (2020). The association between diabetes and cognitive changes during aging. Scandinavian Journal of Primary Health Care, 38(3), 281–290.

The association between diabetes and cognitive changes during aging

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Author: Papunen, Sanna1; Mustakallio-Könönen, Anna1; Auvinen, Juha1;
Organizations: 1Centre for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
2Biocenter Oulu, University of Oulu, Oulu, Finland
3Department of Genomics of Complex Diseases, School of Public Health, Imperial College London, London, UK
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.1 MB)
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Language: English
Published: Informa, 2020
Publish Date: 2020-09-08


Background/Objectives: Worldwide, we are observing a rising prevalence of dementia and mild cognitive impairments that often co-occur with the heightened incidence of non-communicable diseases in the elderly. It is suggested that type 2 diabetes and defects in glucose metabolism might predispose to poorer cognitive performances and more rapid decline in old age.

Methods: To address existing knowledge gaps in this area, we systematically reviewed the literature to identify whether patients with type 2 diabetes (T2DM) and pre-diabetes are at a higher risk of poorer cognitive performance, and whether the risk (if any) might affect specific cognitive abilities. We concentrated the review on elderly individuals (65 years or older) at intake. In total, 3251 original articles were retrieved, of which 17 met our inclusion and quality control criteria, which comprised 12 structured questions used to define the articles.

Results: 11 of 17 studies found a statistically significant decline in cognition among individuals who had T2DM or pre-diabetes compared to their non-diabetic counterparts. The association between diabetes and cognitive decline was not always clear, and the extent of the cognitive tests used seemed to have the greatest effect on the results.

Conclusion: Focusing on a population age 65 years and over, we found insufficient evidence to support an association between pre-diabetes stages and mild cognitive impairment. However, there is consistent evidence to support diabetes as an independent risk factor for low cognitive ability in the elderly. Finally, we found insufficient evidence to support effect of T2DM on distinct cognitive ability due to the scarcity of comparable findings.

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Series: Scandinavian journal of primary health care
ISSN: 0281-3432
ISSN-E: 1502-7724
ISSN-L: 0281-3432
Volume: 38
Issue: 3
Pages: 281 - 290
DOI: 10.1080/02813432.2020.1802140
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article.
Copyright information: © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.