Dementia in Elderly Diabetic Patients

Effects of Glycemic Control

Abstract

The clinical data of 10 elderly diabetics who developed dementia were assessed to elucidate factors affecting dementia. When the frequency distribution of FBG and HbA1c levels in elderly diabetics was investigated, dementia was found to occur frequently in both well-controlled and poorly controlled diabetics. The diabetics were then divided into a well-controlled group (n=6) and a poorly controlled group (n=4) according to their degree of glycemic control. Non-demented diabetics matched for age, sex, BMI, duration and treatment served as a matched-control group (n=10). FRG and MA1c. were reviewed retrospectively to assess the effects of preceding glycemic control on mental deterioration. HbA1c. levels were significantly lower in the well-controlled group and higher in the poorly controlled group than in the matched-control group beginning 12 months before the onset of dementia but differences in FBG values were not significant. Thus, it was concluded that chronic hyperglycemia with HbA1c levels over 10% for a year can serve as a risk factor for vascular dementia with CVA and hypertension and that even chronic subclinical hypoglycemia with HbA1c, levels below 7% for a year can serve as a risk factor for hypoglycemic dementia with or without vascular dementia in elderly diabetics over 75 years of age treated with insulin or oral hypoglycemic agents.