The relationship between type 2 diabetes and cognitive dysfunction: longitudinal studies and their methodological limitations
The relationship between type 2 diabetes and cognitive dysfunction: longitudinal studies and their methodological limitations
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DOI：
10.1016/j.ejphar.2004.02.054
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发表时间：
2004-04-19
影响因子：
5
通讯作者：
Strachan, MWJ
中科院分区：
文献类型：
--
作者：
Allen, KV;Frier, BM;Strachan, MWJ
2型糖尿病和老年痴呆症是主要的公共卫生问题。横断面研究表明，这两种情况可能是相互关联的，但这种关联的性质是不确定的。因果关系只能通过纵向设计的研究来建立，考虑到任何认知研究中的许多潜在混杂因素。文献检索确定了10项研究（9项基于人群，1项病例对照设计），包括可定义的糖尿病人群以及基线和随访时的认知功能评估。这10项研究在认知功能评估中结合了特定领域的认知评估和痴呆的临床诊断。在九项基于人群的研究中，有八项研究表明糖尿病与认知能力下降加速或痴呆症发病率增加有关。一项研究证明了糖尿病和血管性认知障碍之间的关系，但与其他类型的痴呆症无关。在病例对照研究中，2型糖尿病和认知能力下降之间没有关联。这些研究提供了令人信服的证据来支持这样的观点，即与普通人群相比，2型糖尿病患者患认知障碍的风险增加。(C)2004 Elsevier B.V.保留所有权利。
Type 2 diabetes and dementia in the elderly are major public health problems. Cross-sectional studies have suggested that these two conditions may be inter-related, but the nature of this association is uncertain. Causation can only be established through studies with a longitudinal design, taking into account the many potential confounding factors in any study of cognition. A literature search has identified 10 studies (nine population-based and one of case-controlled design) that included a definable diabetic population and assessments of cognitive function at baseline and at follow-up. These 10 studies utilised a combination of domain-specific cognitive assessments and a clinical diagnosis of dementia in the assessment of cognitive function. Diabetes was associated with either an accelerated cognitive decline or an increased incidence of dementia in eight of nine of the population-based studies. One study demonstrated a relationship between diabetes and vascular cognitive impairment, but not with other types of dementia. No association between type 2 diabetes and cognitive decline was demonstrated in the case-controlled study. These studies provide compelling evidence to support the view that people with type 2 diabetes are at increased risk of developing cognitive impairment in comparison with the general population. (C) 2004 Elsevier B.V. All rights reserved.