J Neurol Neurosurg Psychiatry 76:1466-1467 doi:10.1136/jnnp.2005.062737
  • Letter

Mild impairments in cognition in patients with type 2 diabetes mellitus: the use of the concepts MCI and CIND

  1. E van den Berg,
  2. R P C Kessels,
  3. E H F de Haan,
  4. L J Kappelle,
  5. G J Biessels
  1. Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre, Utrecht, Netherlands
  1. Correspondence to:
 Dr Geert Jan Biessels
 Department of Neurology, G03.228, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, Netherlands;

    Type 2 diabetes mellitus (DM2) is associated with moderate cognitive impairment in verbal memory, mental flexibility, and information processing speed, while other cognitive functions remain relatively unaffected.1 Moreover, epidemiological studies have shown that DM2 patients have a twofold increased risk of developing either vascular dementia or Alzheimer’s disease.1,2 In the present study we examined whether mild cognitive impairment (MCI) and “cognitive impairment, no dementia” (CIND)—two concepts that are used to describe cognitive impairment in the transitional state between normal aging and early dementia—can be applied to the cognitive impairments encountered in a population based sample of DM2 patients. Recently, these concepts have attracted considerable attention, as individuals who meet the criteria for either MCI or CIND are known to have a substantially increased risk of developing dementia.3,4 MCI is defined as a memory deficit without impairments in other cognitive domains.3 Patients with MCI develop Alzheimer’s disease at an annual incidence of between 6% and 25%, compared with 0.2–3.9% in the general population of the same age. The broader concept of CIND is used to describe more general cognitive impairments, often encountered in relation to vascular risk factors. The diagnosis requires impairment in one or more cognitive domains and no dementia.5 A fivefold increased risk of developing Alzheimer’s disease, vascular dementia, or mixed Alzheimer/vascular dementia has been reported in patients with CIND.4 If either of the concepts MCI or CIND is …

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