People with type 2 diabetes and screen-detected cognitive impairment use acute health care services more often: observations from the COG-ID study.

Background: Patients with type 2 diabetes have an increased risk of cognitive impairment which can lead to impaired diabetes self-management and an increased risk of diabetes-related complications. Routine screening for cognitive impairment in elderly patients with type 2 diabetes is therefore increasingly advocated. The aim of this study is to investigate whether people with type 2 diabetes and screen-detected cognitive impairment use acute health care services more often than patients not suspected of cognitive impairment.

Depressive symptoms and quality of life after screening for cognitive impairment in patients with type 2 diabetes: observations from the Cog-ID cohort study.

Objectives: To assess changes in depressive symptoms and health-related quality of life (HRQOL) after screening for cognitive impairment in people with type 2 diabetes.

Design: A prospective cohort study, part of the Cognitive Impairment in Diabetes (Cog-ID) study.

Setting: Participants were screened for cognitive impairment in primary care.

Applicability of diagnostic constructs for cognitive impairment in patients with type 2 diabetes mellitus.

Aims: Type 2 diabetes mellitus (T2DM) is associated with subtle cognitive changes, but also with more severe stages of cognitive dysfunction, including mild cognitive impairment (MCI) and dementia. For these severe stages, it is uncertain which domains are primarily affected and if all patients with impairment are captured by formal criteria for MCI or dementia.

Methods: Ninety-five patients with T2DM suspected of cognitive impairment, identified through screening in primary care, underwent neuropsychological examination assessing five different domains.

How to choose the most appropriate cognitive test to evaluate cognitive complaints in primary care.

Background: Despite the wealth of research devoted to the performance of individual cognitive tests for diagnosing cognitive impairment (including mild cognitive impairment and dementia), it can be difficult for general practitioners to choose the most appropriate test for a patient with cognitive complaints in daily practice. In this paper we present a diagnostic algorithm for the evaluation of cognitive complaints in primary care. The rationale behind this algorithm is that the likelihood of cognitive impairment -which can be determined after history taking and an informant interview- should determine which cognitive test is most suitable.

Undiagnosed cognitive impairment, health status and depressive symptoms in patients with type 2 diabetes.

Aims: Type 2 diabetes (T2DM) is associated with cognitive impairment. We examined whether undiagnosed cognitive impairment in T2DM-patients is associated with a reduced health status and depressive symptoms.

Methods: In an observational study, 225 T2DM-patients aged ≥70years were examined at their homes and (some of them) at a memory clinic for undiagnosed cognitive impairment (dementia or mild cognitive impairment [MCI], defined according to internationally accepted criteria).

Cognitive Impairment in Diabetes: Rationale and Design Protocol of the Cog-ID Study.

Background: Cognitive impairment frequently co-occurs with type 2 diabetes but is often undiagnosed. Cognitive impairment affects self-management leading to treatment-related complications.

Objective: The aim of this study is to develop a stepped diagnostic procedure, consisting of a screening test complemented by an evaluation by a general practitioner (GP), to detect undiagnosed cognitive impairment in older people with type 2 diabetes.

Cognitive function in patients with diabetes mellitus: guidance for daily care.

Diabetes mellitus is associated with an increase in the risk of dementia and the proportion of patients who convert from mild cognitive impairment (MCI) to dementia. In addition to MCI and dementia, the stages of diabetes-associated cognitive dysfunction include subtle cognitive changes that are unlikely to affect activities of daily life or diabetes self-management. These diabetes-associated cognitive decrements have structural brain correlates detectable with brain MRI, but usually show little progression over time.

Cognitive disorders in diabetic patients.

This chapter gives an overview of the literature on cognitive dysfunction in adults with type 1 or type 2 diabetes. First, methods to evaluate cognitive functioning and the pattern and severity of cognitive dysfunction in relation to diabetes will be discussed. The reader will note that diabetes is associated with worse cognitive functioning and an increased dementia risk.

Screening for increased cardiometabolic risk in primary care: a systematic review.

Background: Many programmes to detect and prevent cardiovascular disease (CVD) have been performed, but the optimal strategy is not yet clear.

Aim: To present a systematic review of cardiometabolic screening programmes performed among apparently healthy people (not yet known to have CVD, diabetes, or cardiometabolic risk factors) and mixed populations (apparently healthy people and people diagnosed with risk factor or disease) to define the optimal screening strategy.

Design And Setting: Systematic review of studies performed in primary care in Western countries.

The "Test Your Memory" test performs better than the MMSE in a population without known cognitive dysfunction.

Aim: To examine the relation of performance on the self-administered Test Your Memory test (TYM) and the Mini-Mental State Examination (MMSE) with a comprehensive neuropsychological assessment in a population sample including people with modest cognitive decrements.

Methods: Eighty-six participants (aged 56-77 years), without known cognitive dysfunction, performed a neuropsychological assessment including MMSE, and were asked to fill out the TYM. The relation between both the TYM and the MMSE and a neuropsychological assessment was examined by means of correlation analyses, area under the ROC curves for discriminating between a "normal" and "modest decrements"(≥1SD below the sample mean) group, and Bland-Altman plots.

Mild depressive symptoms do not influence cognitive functioning in patients with type 2 diabetes.

Type 2 diabetes (T2DM) is associated both with cognitive decrements and depressive symptoms. Since depression in itself has been associated with cognitive decrements we aimed to investigate the influence of depressive symptoms on the relation between T2DM and cognitive functioning. Data were derived from three independent studies on cognitive functioning in patients with T2DM (n=366) and controls without diabetes (n=204), two with longitudinal and one with only cross-sectional assessments.

High-sensitivity C-reactive protein to detect metabolic syndrome in a centrally obese population: a cross-sectional analysis.

Background: People with central obesity have an increased risk for developing the metabolic syndrome, type 2 diabetes and cardiovascular disease. However, a substantial part of obese individuals have no other cardiovascular risk factors, besides their obesity. High sensitivity C-reactive protein (hs-CRP), a marker of systemic inflammation and a predictor of type 2 diabetes and cardiovascular disease, is associated with the metabolic syndrome and its separate components.

Intensive multifactorial treatment and cognitive functioning in screen-detected type 2 diabetes--the ADDITION-Netherlands study: a cluster-randomized trial.

Aim: To assess whether an intensive multifactorial treatment can reduce cognitive decrements and cognitive decline in screen-detected type 2 diabetes.

Methods: The multinational ADDITION-study, a cluster-randomized parallel group trial in patients with screen-detected type 2 diabetes, compared the effectiveness of intensive multifactorial treatment (IT; lifestyle advice and strict regulation of metabolic parameters) with routine care (RC) on cardiovascular outcome. In The Netherlands randomization was stratified according to practice organization.