Diabetes-specific dementia risk score (DSDRS) predicts cognitive performance in patients with type 2 diabetes at high cardio-renal risk

Chloë Verhagen,Jolien Janssen,Lieza G Exalto,Esther Van Den Berg,Odd Erik Johansen,Geert Jan Biessels

doi:10.1016/j.jdiacomp.2020.107674

Abstract

AimTo investigate the relationship between the diabetes-specific dementia risk score (DSDRS) and concurrent and future cognitive impairment (CI) in type 2 diabetes (T2D). MethodsDSDRS were calculated for participants with T2D aged ≥60 years from the CARMELINA-cognition substudy (ClinicalTrials.gov Identifier: NCT01897532). Cognitive assessment included Mini-Mental State Examination (MMSE) and a composite attention and executive functioning score (A&E). The relation between baseline DSDRS and probability of CI (MMSE < 24) and variation in cognitive performance was assessed at baseline (n = 2241) and after 2.5 years follow-up in patients without baseline CI (n = 1312). ResultsHigher DSDRS was associated with a higher probability of CI at baseline (OR = 1.17 per point, 95% CI 1.12–1.22) and follow-up (OR = 1.24 per point, 95% CI 1.14–1.35). Moreover, in patients without baseline CI, higher DSDRS was also associated with lower baseline cognitive performance (MMSE: F(1, 1930) = 47.07, p < .0001, R2 = 0.02); A&E z-score: (F(1, 1871) = 33.44 p < .0001, R2 = 0.02) and faster cognitive decline at follow-up (MMSE: F(3, 1279) = 38.41, p < .0001; A&E z-score: F(3, 1206) = 148.48, p < .0001). ConclusionsThe DSDRS identifies patients with T2D at risk of concurrent as well as future CI. The DSDRS may thus be a supportive tool in screening strategies for cognitive dysfunction in patients with T2D.

Highlights

People with type 2 diabetes (T2D) are twice as likely to develop dementia compared to people without diabetes.[1]
It is not clear yet if the Diabetes-specific dementia risk score (DSDRS) can identify individuals with T2D with concurrent cognitive dysfunction cross-sectionally. It is unknown if the DSDRS is able to predict future cognitive decline, even when it is less severe than frank dementia
Verhagen et al / Journal of Diabetes and Its Complications xxx (xxxx) xxx part of a multicenter, international, randomized, double blind study in patients with type 2 diabetes at high cardio-renal risk (CARMELINA®: ClinicalTrials.gov Identifier: NCT01897532) that investigated if treatment with linagliptin vs placebo resulted in a lower incidence of accelerated cognitive decline

Summary

Introduction

People with type 2 diabetes (T2D) are twice as likely to develop dementia compared to people without diabetes.[1]. In 2013, the diabetes-specific dementia risk score (DSDRS) was introduced to help researchers and clinicians identify T2D individuals at risk of developing dementia.[7] The DSDRS predicts the 10-year dementia risk in patients with T2D and incorporates several readily available. The DSDRS was developed based on a population-based registry, without availability of formal cognitive testing in all individuals. It is not clear yet if the DSDRS can identify individuals with T2D with concurrent cognitive dysfunction cross-sectionally. It is unknown if the DSDRS is able to predict future cognitive decline, even when it is less severe than frank dementia

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