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Diabetes-linked cognitive decline is driven by age, sex, vascular risks, and poor glycemic control, highlighting the targeted interventions.  

Researchers conducted a retrospective study published in June 2025 in the issue of Frontiers in Endocrinology to investigate individuals with type 2 diabetes mellitus (T2DM) and determine clinical, lifestyle, and biochemical risk factors associated with mild cognitive impairment (MCI).  

They followed PRISMA guidelines to search 5 databases for studies published between January 1, 2014, and December 31, 2024. Screening was done using predefined criteria, and 2 researchers independently extracted the data. Study quality was estimated using the Newcastle-Ottawa Scale (NOS) and the Joanna Briggs Institute (JBI) tools. Data analysis was conducted in RevMan software using odds ratio (OR) and 95%CI as effect size measures. Heterogeneity was evaluated using I <sup style=”vertical-align: sup;”>2</sup> statistics, and subgroup analyses were performed for variables with ≥10 studies.  

The results showed that 30 studies with 10,469 participants were analyzed, revealing a 44.1% prevalence of MCI in individuals with T2DM. Significant associations were observed with age (OR = 1.06, P = 0.01), female sex (OR = 1.23, P = 0.05), and diabetes duration (OR = 1.07, P = 0.03). Lower education levels were linked to higher risk (OR = 0.82, P = 0.0001), along with smoking (OR = 1.44, P = 0.003), hypertension (OR = 2.25, P < 0.001), and cardiovascular disease (CVD) (OR = 2.61, P < 0.001). Glycated hemoglobin (HbA1c) was associated with cognitive decline (OR = 1.33, P = 0.001), as was insulin resistance measured by homeostasis model assessment (HOMA-IR) (OR = 1.95, P = 0.02).  

Investigators concluded that advanced age, female sex, prolonged diabetes duration, poor glycemic control, and low education were key predictors of MCI in T2DM, with risks amplified by vascular and metabolic factors. 

Source: frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1617248/full