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25-08-2009 | Diabetes | Article

Cognitive dysfunction increases risk for CV events in Type 2 diabetics

Abstract

Free abstract

MedWire News: Individuals with Type 2 diabetes who have impaired cognitive function are at increased risk for cardiovascular (CV) events and death, report researchers in the journal Diabetologia.

The team also found that diabetic patients with severe cognitive dysfunction were twice as likely to experience severe hypoglycemia as those with normal cognitive function.

“Among older patients with diabetes, reduced survival has been reported in those with poor cognitive function,” say Sophia Zoungas (Monash University, Melbourne, Australia) and colleagues.

In this study, the authors quantified mortality and evaluated the CV risks associated with cognitive dysfunction in 11,140 Type 2 diabetics aged 55 years or older participating in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial.

Cognitive function was assessed at baseline using the Mini-Mental State Examination. A score of 28–30 indicated “normal” cognitive function (n=8689), a score of 24–27 indicated “mild dysfunction” (n=2231), and a score of less than 24 indicated “severe dysfunction” (n=212).

Over a median follow-up period of 5 years, 1147 (10.3%) participants experienced a major CV event.

The researchers found that, compared with patients with normal cognitive function, those with mild or severe cognitive function had a significant 27% increased risk for major CV events, a 41% increased risk for CV death, and a 33% increased risk of all-cause death.

They also found that severe, but not mild, cognitive dysfunction increased the risk for severe hypoglycemia 2.10 fold compared with normal cognitive function.

“Our data show that cognitive dysfunction further increases the already greater risk of CV events and death… in patients with Type 2 diabetes,” conclude the authors.

“This is clinically relevant, as cognitive decline is common among patients with Type 2 diabetes and may influence management.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

By Helen Albert