Cognitive decline in older Mexican Americans with diabetes

Objective: To examine social, demographic and health factors associated with cognitive decline over a seven-year period among older Mexican Americans with diabetes. Methods: A population-based sample of 808 noninstitutionalized Mexican Americans aged >= 65 years with diabetes who had a Mini-Mental State Examination (MMSE) > 17 at baseline from the Hispanic Established Population for the Epidemiological Study of the Elderly (H-EPESE). Measurements included sociodemographics, diabetic treatment received (oral hypoglycemic or insulin), self-reported medical conditions, self-reported diabetes-related complications, high depressive symptoms and ADL limitations. Results: The mean MMSE score at baseline was 25.3 (SD=3.7). The rate of decline in cognitive function (MMSE) during the follow-up period was 0.37 point per year. Using general linear mixed models, we found that being male, and having high depressive symptoms and diabetic complications (kidney impairment, circulation problems or limb amputation) were factors significantly associated with greater declines in MMSE score over time. Conclusion: Circulation problems, kidney impairment and depression are the major factors associated with cognitive decline in older Mexican Americans with diabetes.