Depressive symptoms mediate the relationship between diabetes and cognitive performance in a community-based sample of older adults

Claire J. Hoogendoorn, Jiyue Qin, Cuiling Wang, Nelson Roque, Jean Philippe Laurenceau, Mindy J. Katz, Carol A. Derby, Richard B. Lipton, Jeffrey S. Gonzalez

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Aims: To evaluate whether diabetes and prediabetes are associated with impaired cognitive performance among older adults and examine depressive symptoms as a mediator. Methods: We used cross-sectional data from the Einstein Aging Study, a systematically recruited, community-based cohort study of diverse older adults (N = 794; Age Mean (SD) = 78.9 (5.3); 64.4% Non-Hispanic White, 28.7% Non-Hispanic Black, 5.7% Hispanic). Diabetes status was established via self-reported diagnosis, prescribed medications, and fasting blood glucose. Depressive symptoms were assessed using the Geriatric Depression Scale. Cognitive tests included Digit Symbol, Trails-B, Free Recall, Category Fluency, Boston Naming, and Block Design. Linear regression and mediation analyses were applied. Results: Compared to those without diabetes, diabetes was associated with worse performance on all cognitive tests (ps < 0.05), except Trails-B (p = 0.53), and increased depressive symptoms (p < 0.01). For diabetes, mediation via increased depressive symptoms was observed for Free Recall (p = 0.044), Category Fluency (p = 0.033), and Boston Naming (p = 0.048). Conclusions: Diabetes was consistently associated with worse cognitive performance and increased depressive symptoms among this older cohort, while prediabetes was not. Mediation findings suggest depressive symptoms may be a biobehavioral pathway linking diabetes and cognition, though the temporal sequence is unclear. If causal, addressing both diabetes and depressive symptoms among older adults may protect cognitive function.

Original languageEnglish (US)
Article number108183
JournalJournal of Diabetes and Its Complications
Issue number7
StatePublished - Jul 2022


  • Alzheimer's disease
  • Cognitive performance
  • Depressive symptoms
  • Older adults
  • Type 2 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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