Medalists on average performed slightly worse than those without diabetes. In the psychomotor test, the researchers looked at how quickly and well subjects inserted small key-shaped pegs into similarly shaped slots that have been rotated to require fine motor dexterity. While this has been known for people with type 2 diabetes, the changes in memory in aging people with type 1 diabetes had not been clearly established. Performance was significantly but not dramatically lower in people with either form of diabetes than in people lacking the disease. The memory tests required participants to recall a list of words immediately after presentation as well as after a 30-minute delay. Their investigation included standard tests for memory, psychomotor speed and executive function (higher cognitive processes involved in decision-making). The scientists tested and compared cognition in 82 Medalists, 31 age-matched individuals with type 2 diabetes and 30 age-matched non-diabetic controls. Most strikingly, "the memory changes are associated with cardiovascular disease," says Hillary Keenan, PhD, a former principal investigator on the Medalist study and corresponding author on the paper. Joslin investigators also examined how various measures of cognitive health among these Medalists might correspond to common diabetes complications. The mild cognitive declines don't appear in clinical signs for these Medalists, who remain in the normal range of function for people their age, emphasizes Musen, who is lead author on the paper about the work published in Diabetes Care.
The work is the first to evaluate whether cognitive function is changing in an aging group of people who have successfully managed their type 1 diabetes, a very complex disease associated with many complications, for from 50 to more than 80 years. The study compared Joslin 50-year Medalists, who have lived successfully with type 1 diabetes for at least that long, with other people of similar age with type 2 diabetes or without diabetes, says Gail Musen, PhD, an assistant investigator in Joslin's Research Division.
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