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Type 2 diabetes mellitus, cognitive impairment and dementia
Stewart R, Liolitsa D.. Diabetic medicine : a journal of the British Diabetic Association, 1999-02-01
Topic: Risk, prevention and care in population studies
Aims We set out to examine the evidence for an association between cognitive impairment or dementia and the presence of Type 2 diabetes mellitus (DM). We also sought evidence of potential mechanisms for such an association. Methods A literature search of three databases was performed and the reference lists of the papers so identified were examined, using English language papers only. Results We found evidence of cross-sectional and prospective associations between Type 2 DM and cognitive impairment, probably both for memory and executive function. There is also evidence for an elevated risk of both vascular dementia and Alzheimer's disease in Type 2 DM albeit with strong interaction of other factors such as hypertension, dyslipidaemia and apolipoprotein E phenotype. Both vascular and non-vascular factors are likely to play a role in dementia in diabetes. Conclusions Current classification structures for dementia may not be adequate in diabetes, where mixed pathogenesis is likely. Further research into the mechanisms of cognitive impairment in Type 2 DM may allow us to challenge the concept of dementia, at least in these patients, as an irremediable disease.
Key findings
- Results We found evidence of cross-sectional and prospective associations between Type 2 DM and cognitive impairment, probably both for memory and executive function.
Why it matters
This review found evidence linking Type 2 diabetes to cognitive impairment and to higher risk of vascular dementia and Alzheimer's disease, with other factors such as hypertension and apolipoprotein E also involved. It suggests further research into mechanisms may challenge the idea that dementia is always irreversible, but offers no treatment or cure.
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Study details
- Study designcross-sectional
- Evidence strengthLow
How this study scored 51/100
Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for sample size, effect reported and randomised / blinded because the record does not state it. We have no data on institution's track record, so that was left out: it earned 49 of the 97 points we could judge it on, which is 51 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Diabetic medicine : a journal of the British Diabetic Association) |
| Journal's citation record | 2 / 4 | Diabetic Medicine: journal h-index 208 (OpenAlex, 2026-10-29) |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1999 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (pubmed indexes it as a clinical or observational study) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 561 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 19.3 citations a year over 29 year(s) since 1999 |
| Impact for its field and year | 4 / 6 | Cited 8.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 18 other studies in this library |
| Still being cited | 2 / 4 | Cited 26 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Danae Liolitsa: h-index 14 (OpenAlex, whole career) |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 0 institution(s) in 0 countries — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 10229302) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 49 / 97 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 49 of the 97 points we could judge it on is 51 out of 100. |
| Total | 51 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Stewart, R., & Liolitsa, D. (1999). Type 2 diabetes mellitus, cognitive impairment and dementia. Diabetic medicine : a journal of the British Diabetic Association. https://doi.org/10.1046/j.1464-5491.1999.00027.x
Vancouver
Stewart R, Liolitsa D. Type 2 diabetes mellitus, cognitive impairment and dementia. Diabetic medicine : a journal of the British Diabetic Association. 1999. doi:10.1046/j.1464-5491.1999.00027.x. PMID: 10229302.
BibTeX
@article{stewart1999-10229302,
author = {Stewart, R. and Liolitsa, D.},
title = {{Type 2 diabetes mellitus, cognitive impairment and dementia}},
journal = {Diabetic medicine : a journal of the British Diabetic Association},
year = {1999},
doi = {10.1046/j.1464-5491.1999.00027.x},
pmid = {10229302},
url = {https://doi.org/10.1046/j.1464-5491.1999.00027.x}
}
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