Heterogeneous Trajectories of Cognitive Function in Older Adults with Diabetes: Findings from the Korean Longitudinal Study of Aging (KLoSA)

Abstract

Background: Given the rapidly aging population and increasing diabetes prevalence in Korea and worldwide, maintaining optimal cognitive function is a concern in older adults with diabetes. This study aimed to identify heterogeneous trajectories of cognitive function in older adults with diabetes based on the Mini-Mental State Examination and characterize these trajectories. Methods: Study participants consisted of 672 community-dwelling Korean older adults with diabetes, and data were obtained from the population-based Korean Longitudinal Study of Aging from 2006 through 2016. Growth mixture modeling (GMM) was employed to identify distinct trajectories of cognitive function in older adults with diabetes. Results: We found that older adults with diabetes followed five distinct cognitive function trajectories over 10 years: normal-maintained (41.5%), normal-declined (23.8%), mildly impaired-maintained (17.1%), mildly impaired-declined (11.2%), and severely impaired-declined (6.4%). Also, we found that age, gender, household income, and self-rated health status at baseline were associated with these trajectories. Conclusions: Our identification and characterization of heterogeneous cognitive function trajectories in older adults with diabetes have significant implications for developing tailored interventions to older adults with diabetes, specifically to whom at heightened risk for cognitive decline and consequent deterioration in essential diabetes self-management activities.