Age and Ageing Advance Access originally published online on May 10, 2004
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Age and Ageing 2004; 33: 355-361
Age and Ageing Vol. 33 No. 4 © British Geriatrics Society 2004; all rights reserved
Research Paper |
Comorbid type 2 diabetes mellitus and hypertension exacerbates cognitive decline: evidence from a longitudinal study
1 Department of Psychology, Göteborg University, Göteborg, Sweden
2 Department of Human Development and Family Studies and 3 Center for Developmental and Health Genetics, Pennsylvania State University, University Park, PA, USA
4 Institute of Gerontology, School of Health Sciences, Jönköping, Sweden
5 Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
6 Department of Psychology, University of Southern California, Los Angeles, CA, USA
Address correspondence to: Linda B. Hassing, Department of Psychology, Göteborg University, Box 500, SE-405 30 Göteborg, Sweden. Fax: (+46) 31 773 4628. Email: Linda.Hassing{at}psy.gu.se
Abstract
Background: diabetes and hypertension are two highly prevalent diseases in the old population. They are highly related such that comorbidity is common.
Objectives: to examine (i) the independent impact of the respective diseases on cognitive decline in very old age and (ii) the interactive impact of the two diseases on cognitive decline.
Subjects: 258 individuals (mean age = 83 years), all non-demented at baseline. Of these, 128 individuals (non-cases) were free from diabetes and hypertension, 92 individuals had a diagnosis of hypertension, 16 had a type 2 diabetes mellitus diagnosis without hypertension, and 22 had comorbid diabetes and hypertension.
Method: a population-based longitudinal study of ageing (The OCTO-Twin Study), including four measurement occasions 2 years apart. The Mini-Mental State Examination was used to measure general cognitive function. Data were analysed using SAS Proc Mixed multilevel modelling.
Results: longitudinal trajectories indicated a steeper decline in cognitive function related to diabetes but not related to hypertension. However, the results indicated greatest cognitive decline among persons with comorbid diabetes and hypertension.
Conclusions: it is concluded that comorbidity of diabetes and hypertension produce a pronounced cognitive decline. This finding emphasises the importance of prevention and treatment of those highly prevalent diseases in the old population.
Keywords: hypertension, type 2 diabetes mellitus, cognitive decline, older age, longitudinal study, vascular disease
Received June 13, 2003; Revision received December 29, 2003. accepted in revised form December 29, 2003.
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