Neurocognitive dysfunction in old diabetes: management and treatment.

Type 2 diabetes mellitus (T2DM) is a risk factor for cognitive decline. However, the etiology of dementia and cognitive impairment in people with T2DM is probably multifactorial, and the precise underlying mechanism remains unclear. Good metabolic control in elderly subjects with T2DM may contribute to prevention of the development and/or progression of cognitive decline in elderly diabetic subjects, but hypoglycemia must be avoided. Appropriate well-balanced glycaemic control should be provided to diabetic subjects with cognitive impairment. Demented diabetic patients tend to lose self-caring ability, and behavioural and psychological symptoms of dementia (BPSD) and depressive mood; the symptoms often associated with dementia, make the management of diabetes complicated and difficult. Considering the progressive aging world-wide, more research to investigate the association between T2DM and dementia process, as well as the best way to manage this population, will be important.