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Diabetes is a well-documented risk factor for dementia, but its association with cognitive decline is less well defined. Using data from a prospective cohort study, investigators evaluated whether diabetes in midlife is associated with cognitive decline in more than 13,000 adults in four U.S. communities. At baseline, median age was 57, and 13% of participants had diabetes. Cognitive function was assessed at baseline and twice thereafter; about 6,000 participants attended all three visits.
During median follow-up of 19 years, average decline on cognitive function scores (as measured by a composite of three different neuropsychological tests) was 19% greater among diabetic than nondiabetic patients. Cognitive decline increased with higher bas…