{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T22:19:42Z","timestamp":1791065982877,"version":"4.1.0"},"reference-count":43,"publisher":"American Diabetes Association","issue":"8","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2006,8,1]]},"abstract":"<jats:p>OBJECTIVE\u2014To evaluate the association between cognitive dysfunction and other barriers and glycemic control in older adults with diabetes.<\/jats:p>\n                  <jats:p>RESEARCH DESIGN AND METHODS\u2014Patients over the age of 70 years presenting to a geriatric diabetes clinic were evaluated for barriers to successful diabetes management. Patients were screened for cognitive dysfunction with the Mini Mental State Examination (MMSE) and a clock-drawing test (CDT) scored by 1) a method validated by Mendez et al. and 2) a modified CDT (clock in a box [CIB]). Depression was evaluated with the Geriatric Depression Scale. Interview questionnaires surveyed activities of daily living (ADLs) and instrumental ADLs (IADLs), as well as other functional disabilities.<\/jats:p>\n                  <jats:p>RESULTS\u2014Sixty patients (age 79 \u00b1 5 years, diabetes duration 14 \u00b1 13 years) were evaluated. Thirty-four percent of patients had low CIB (\u22645), and 38% of patients had low CDT (\u226413). Both CIB as well as CDT were inversely correlated with HbA1c, suggesting that cognitive dysfunction is associated with poor glycemic control (r = \u22120.37, P &amp;lt; 0.004 and r = \u22120.38, P &amp;lt; 0.004, respectively). Thirty-three percent of patients had depressive symptoms with greater difficulty completing the tasks of the IADL survey (5.7 \u00b1 1.7 vs. 4.6 \u00b1 2.0; P &amp;lt; 0.03). These older adults with diabetes had a high incidence of functional disabilities, including hearing impairment (48%), vision impairment (53%), history of recent falls (33%), fear of falls (44%), and difficulty performing IADLs (39%).<\/jats:p>\n                  <jats:p>CONCLUSIONS\u2014Older adults with diabetes have a high risk of undiagnosed cognitive dysfunction, depression, and functional disabilities. Cognitive dysfunction in this population is associated with poor diabetes control.<\/jats:p>","DOI":"10.2337\/dc06-0506","type":"journal-article","created":{"date-parts":[[2006,7,27]],"date-time":"2006-07-27T17:28:08Z","timestamp":1154021288000},"page":"1794-1799","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":272,"title":["Cognitive Dysfunction Is Associated With Poor Diabetes Control in Older Adults"],"prefix":"10.2337","volume":"29","author":[{"given":"Medha","family":"Munshi","sequence":"first","affiliation":[{"name":"Division of Adult Diabetes, Joslin Diabetes Center, Boston, Massachusettes"},{"name":"Gerontology Division, Beth Israel Deaconess Medical Center, Boston, Massachusettes"},{"name":"Department of Medicine, Harvard Medical School, Boston, Massachusettes"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Grande","sequence":"additional","affiliation":[{"name":"Geriatric Neuropsycology Laboratory, New England Geriatric Research, Education, and Clinical Center, Veterans Affairs Boston Health Care System, Boston, Massachusettes"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mellody","family":"Hayes","sequence":"additional","affiliation":[{"name":"Division of Adult Diabetes, Joslin Diabetes Center, Boston, Massachusettes"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darlene","family":"Ayres","sequence":"additional","affiliation":[{"name":"Division of Adult Diabetes, Joslin Diabetes Center, Boston, Massachusettes"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmy","family":"Suhl","sequence":"additional","affiliation":[{"name":"Division of Adult Diabetes, Joslin Diabetes Center, Boston, Massachusettes"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Capelson","sequence":"additional","affiliation":[{"name":"Division of Adult Diabetes, Joslin Diabetes Center, Boston, Massachusettes"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Adult Diabetes, Joslin Diabetes Center, Boston, Massachusettes"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Milberg","sequence":"additional","affiliation":[{"name":"Geriatric Neuropsycology Laboratory, New England Geriatric Research, Education, and Clinical Center, Veterans Affairs Boston Health Care System, Boston, Massachusettes"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Weinger","sequence":"additional","affiliation":[{"name":"Division of Adult Diabetes, Joslin Diabetes Center, Boston, Massachusettes"},{"name":"Department of Medicine, Harvard Medical School, Boston, Massachusettes"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","reference":[{"key":"2022031219233704400_R1","doi-asserted-by":"crossref","unstructured":"Yaffe K, Blackwell T, Kanaya AM, Davidowitz N, Barrett-Connor E, Krueger K: Diabetes, impaired fasting glucose, and development of cognitive impairment in older women. 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