ArticlePloS one2026
Type 2 diabetes and age-related cognitive decline over 40 years in Danish men-A cohort study based on the Danish Aging and Cognition (DanACo) cohort.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimThe extant literature on type 2 diabetes and cognitive decline is based on short cognitive follow-ups and assessments of baseline cognitive ability after diagnosis. The objective was to investigate the influence of type 2 diabetes on cognitive decline over a period of on average 44 years. MATERIALS AND
methodsThis cohort study included 5,147 men from the Danish Aging and Cognition cohort consisting of a late mid-life (mean age 64.2 years) follow-up of men with intelligence test scores (IQ) available from statutory conscription board examinations in young adulthood (mean age 20.4 years). Follow-up included re-administration of the conscription board intelligence test and a comprehensive questionnaire. Exposure was self-reported but register-based type 2 diabetes and duration of disease were also calculated. Cognitive decline was defined as both IQ change (baseline-follow-up) and significant IQ decline based on the reliable change index (cut-off: 13.2 IQ-points). Associations were analyzed in linear and logistic regression models.
resultsMen having type 2 diabetes had a 1.81 IQ points (95%CI:1.14,2.49) larger decline compared to men without diabetes when adjusting for baseline IQ, years of education, follow-up age, retest interval, depression, and smoking status. Moreover, type 2 diabetes was associated with 1.42 times higher odds of a significant IQ decline and longer duration was associated with a larger, though not statistically significant, decline. The participation rate was 13.4%, and the participants were healthier and more well-educated than non-participants. To account for potential selection bias, inverse probability weights (IPW) were calculated based on baseline characteristics. The analyses applying these weights yielded similar estimates.
conclusionType 2 diabetes was associated with modestly greater cognitive decline and higher odds of a statistically significant (>13.2 IQ points) and clinically relevant decline. Finally, the alignment between main and IPW results indicates the findings are robust and likely generalizable.
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