Comorbid type 2 diabetes mellitus and hypertension exacerbates cognitive decline: Evidence from a longitudinal study

Linda B. Hassing, Scott Hofer, Sven E. Nilsson, Stig Berg, Nancy L. Pedersen, Gerald McClearn, Boo Johansson

Research output: Contribution to journalArticle

170 Scopus citations


Background: Diabetes and hypertension are two highly prevalent diseases in the old population. They are highly related such that comorbidity is common. Objectives: To examine (i) the independent impact of the respective diseases on cognitive decline in very old age and (ii) the interactive impact of the two diseases on cognitive decline. Subjects: 258 individuals (mean age = 83 years), all non-demented at baseline. Of these, 128 individuals (non-cases) were free from diabetes and hypertension, 92 individuals had a diagnosis of hypertension, 16 had a type 2 diabetes mellitus diagnosis without hypertension, and 22 had comorbid diabetes and hypertension. Method: A population-based longitudinal study of ageing (The OCTO-Twin Study), including four measurement occasions 2 years apart. The Mini-Mental State Examination was used to measure general cognitive function. Data were analysed using SAS Proc Mixed multilevel modelling. Results: Longitudinal trajectories indicated a steeper decline in cognitive function related to diabetes but not related to hypertension. However, the results indicated greatest cognitive decline among persons with comorbid diabetes and hypertension. Conclusions: It is concluded that comorbidity of diabetes and hypertension produce a pronounced cognitive decline. This finding emphasises the importance of prevention and treatment of those highly prevalent diseases in the old population.

Original languageEnglish (US)
Pages (from-to)355-361
Number of pages7
JournalAge and Ageing
Issue number4
Publication statusPublished - Jul 2004
Externally publishedYes



  • Cognitive decline
  • Hypertension
  • Longitudinal study
  • Older age
  • Type 2 diabetes mellitus
  • Vascular disease

ASJC Scopus subject areas

  • Aging

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