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Diabetes, impaired fasting glucose, and development of cognitive impairment in older women
Yaffe K, Blackwell T, Kanaya AM, Davidowitz N, Barrett-Connor E, Krueger K.. Neurology, 2004-08-01
Topic: Risk, prevention and care in population studies
Objective To investigate the association between diabetes and impaired fasting glucose (IFG) and cognition and risk of developing both dementia and mild cognitive impairment (MCI) in older women. Methods The authors analyzed data from a 4-year randomized trial of raloxifene among 7,027 osteoporotic postmenopausal women (mean age, 66.3 years) at 178 sites. Diabetes was defined by history, fasting blood glucose > or =7.0 mmol/L (> or =126 mg/dL), or use of hypoglycemic agents; IFG was defined as fasting glucose 6.11 mmol/L (110 mg/dL); all others were considered to have normal glucose (NG). The main outcome was baseline and 4-year change on five standardized cognitive tests (z scores with lower scores indicating worse performance) and risk of developing clinically significant impairment (dementia, mild cognitive impairment, or very low cognitive score). Results A total of 267 (3.8%) women had diabetes and 297 (4.2%) had IFG. Women with IFG had worse baseline cognitive scores compared to women with NG but better scores than diabetics (age-adjusted composite z score based on five tests: NG 0.40, 95% CI 0.30 to 0.49; IFG 0.14, 95% CI -0.36 to 0.64; diabetics -0.78, 95% CI -1.23 to -0.33; p Conclusions Diabetic as well as pre-diabetic women have impaired cognitive performance and greater risk of developing cognitive impairment.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Yaffe, K., Blackwell, T., Kanaya, A. M., Davidowitz, N., Barrett-Connor, E., & Krueger, K. (2004). Diabetes, impaired fasting glucose, and development of cognitive impairment in older women. Neurology. https://doi.org/10.1212/01.wnl.0000134666.64593.ba
Vancouver
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. Neurology. 2004. doi:10.1212/01.wnl.0000134666.64593.ba. PMID: 15326238.
BibTeX
@article{yaffe2004-15326238,
author = {Yaffe, K. and Blackwell, T. and Kanaya, A. M. and Davidowitz, N. and Barrett-Connor, E. and Krueger, K.},
title = {{Diabetes, impaired fasting glucose, and development of cognitive impairment in older women}},
journal = {Neurology},
year = {2004},
doi = {10.1212/01.wnl.0000134666.64593.ba},
pmid = {15326238},
url = {https://doi.org/10.1212/01.wnl.0000134666.64593.ba}
}
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Key findings
- The main outcome was baseline and 4-year change on five standardized cognitive tests (z scores with lower scores indicating worse performance) and risk of developing clinically significant impairment (dementia, mild cognitive impairment, or very low cognitive score).
- Results A total of 267 (3.8%) women had diabetes and 297 (4.2%) had IFG.
- Women with IFG had worse baseline cognitive scores compared to women with NG but better scores than diabetics (age-adjusted composite z score based on five tests: NG 0.40, 95% CI 0.30 to 0.49; IFG 0.14, 95% CI -0.36 to 0.64; diabetics -0.78, 95% CI -1.23 to -0.33; p < 0.001).
Why it matters
Among 7,027 postmenopausal women with osteoporosis followed for 4 years in a drug trial, the 267 with diabetes scored clearly lower on cognitive tests at the start (composite score −0.78 vs 0.40 for normal blood sugar), and the authors report that both diabetic and pre-diabetic women had a "greater risk of developing cognitive impairment." Women with borderline-high fasting glucose fell in between, but their estimate was too imprecise to separate them from women with normal glucose. This is an observed association, not evidence that controlling blood sugar prevents dementia — no glucose treatment was tested.
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Study details
- Study designrandomized controlled trial
- Participants267
- Effect sizeor =7.0; 3.8%; 4.2%
- Evidence strengthHigh
How this study scored 77/100
Published in a leading specialty journal, and it is a randomized controlled trial. We have no data on senior author's track record, so that was left out: it earned 74 of the 96 points we could judge it on, which is 77 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomized controlled trial |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2004 — older than 20 years, still counted |
| Sample size | 2 / 4 | 267 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 1 / 2 | Randomized (as stated in the record) |
| Times cited | 6 / 7 | Cited 519 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 21.6 citations a year over 24 year(s) since 2004 |
| Impact for its field and year | 4 / 6 | Cited 10.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 32 other studies in this library |
| Still being cited | 2 / 4 | Cited 35 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | OpenAlex's profile for last-listed author K. Krueger holds only 4 work(s), too few to judge a track record — left out of this score |
| Institution's track record | 2 / 3 | University of California, San Francisco: institution h-index 1,915 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 15326238) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 74 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 74 of the 96 points we could judge it on is 77 out of 100. |
| Total | 77 / 100 | — |
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