ArticleAnnals of internal medicine2014
Diabetes in midlife and cognitive change over 20 years: a cohort study.
Article in Annals of internal medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 232 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
232 citing papers in PubMed, 3 syntheses or guidelines pooled it, 434 citations in OpenAlex.
- Mechanisms and Pathogenesis of Diabetic Cognitive Impairment: A Comprehensive Review.Aging and disease · 2025Pooled it
- Pooled it
- Guideline
- The Effect Of Visual Deprivation During Cognitive Motor Dual Task Training On Cognitive Function In Type 2 Diabetes Mellitus.F1000Research · 2025Trial
- Reversibility of brain glucose kinetics in type 2 diabetes mellitus.Diabetologia · 2022Trial
- Acute hyperglycaemia leads to altered frontal lobe brain activity and reduced working memory in type 2 diabetes.PloS one · 2021Trial
- Diabetes and Cognitive Decline in Older Adults: The Ginkgo Evaluation of Memory Study.The journals of gerontology. Series A, Biological sciences and medical sciences · 2017Trial
- Effect of a long-term intensive lifestyle intervention on prevalence of cognitive impairment.Neurology · 2017Trial
- ACCORDION MIND: results of the observational extension of the ACCORD MIND randomised trial.Diabetologia · 2017Trial
- A narrative review of what cohorts have taught us and how they have laid the foundation for much of our understanding of type 2 diabetes.Diabetologia · 2026Review
- Cardiometabolic Risk Factors and Domain-Specific Cognitive Function in Prediabetes and Type 2 Diabetes.Medical sciences (Basel, Switzerland) · 2026Article
- Progressive modeling of multiscale hippocampal subfield structural representation improves the prediction performance of mild cognitive impairment in type 2 diabetes.European archives of psychiatry and clinical neuroscience · 2026Article
- Berberine attenuates hyperglycemia induced neurodegeneration in mice by modulation of Nrf2 expression.Molecular biology reports · 2026Article
- Proteomic signature of dementia risk in type 2 diabetes.Journal of advanced research · 2026Article
- [Geriatric aspects of diabetes mellitus (Update 2026)].Wiener klinische Wochenschrift · 2026Review
- Personalised Approach to the Management of Older People with Type 2 Diabetes Mellitus-A Comprehensive Narrative Review.Journal of personalized medicine · 2026Review
- In newly diagnosed diabetes, hyperglycemia is associated with increased brain iron deposition, measured by MRI-based Quantitative Susceptibility Mapping (QSM).Journal of advanced research · 2026Article
- A Longitudinal Investigation of Prediabetes, Diabetes, HbA1c and Cognitive Trajectories Among Cognitively Unimpaired Individuals.Journal of the American Geriatrics Society · 2026Article
- Blood and imaging biomarkers of blood-brain barrier disruption in diabetic individuals with cognitive impairment.Aging clinical and experimental research · 2026Article
- Association between hemoglobin glycation index and cognitive function: Evidence in the elderly.PloS one · 2026Article
172 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- SummaryForPatientsIn
Authors and funding
11 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundType 2 diabetes is associated with dementia risk, but evidence is limited for possible associations of diabetes and prediabetes with cognitive decline.
objectiveTo determine whether diabetes in midlife is associated with 20-year cognitive decline and to characterize long-term cognitive decline across clinical categories of hemoglobin A1c (HbA1c) levels.
designProspective cohort study.
settingThe community-based ARIC (Atherosclerosis Risk in Communities) study.
participants13,351 black and white adults aged 48 to 67 years at baseline (1990 to 1992). MEASUREMENTS: Diabetes was defined by self-reported physician diagnosis or medication use or HbA1c level of 6.5% or greater. Undiagnosed diabetes, prediabetes, and glucose control in persons with diagnosed diabetes were defined by clinical categories of HbA1c level. Delayed word recall, digit symbol substitution, and word fluency tests were used to assess cognitive performance and were summarized with a global Z score.
resultsDiabetes in midlife was associated with a 19% greater cognitive decline over 20 years (adjusted global Z-score difference, -0.15 [;95% CI, -0.22 to -0.08];) compared with no diabetes. Cognitive decline was significantly greater among persons with prediabetes (HbA1c level of 5.7% to 6.4%) than among those with an HbA1c level less than 5.7%. Participants with poorly controlled diabetes (HbA1c level ≥ 7.0%) had greater decline than those whose diabetes was controlled (adjusted global Z-score difference, -0.16; P = 0.071). Longer-duration diabetes was also associated with greater late-life cognitive decline (P for trend < 0.001). Rates of decline did not differ significantly between white and black persons (P for interaction = 0.44). LIMITATION: Single HbA1c measurement at baseline, 1 test per cognitive domain, and potential geographic confounding of race comparisons.
conclusionDiabetes prevention and glucose control in midlife may protect against late-life cognitive decline. PRIMARY FUNDING SOURCE: National Institutes of Health.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.