ABSTRACT
Cognitive dysfunction and depression, imposing a direct impact on quality of life, loss of independence, and demands on caregivers, may ultimately be as great a concern to older people with diabetes as the more traditionally recognized vascular complications. A multitude of cross-sectional studies has been performed to examine the association between diabetes mellitus (DM) and cognitive performance among older persons. In particular, DM was frequently associated with impaired declarative memory, attention, mental flexibility, information processing speed, and frontal lobe/executive functions. The diabetes-related cerebral structural changes, specifically cortical atrophy and cerebrovascular disease, are documented risk factors for the development of cognitive impairment and dementia. Chronic hyperglycemia, a hallmark of DM closely associated with depression, is a well-established predictor of the onset and exacerbation of diabetes complication. Self-care regimens, including medication-taking, self-monitoring of blood glucose, diet control, regular exercise, and smoking cessation, are essential for high-quality diabetes care.
