Impact of antidiabetic medications on physical and cognitive functioning of older mexican americans with diabetes mellitus

PURPOSE: The current study was designed to evaluate the utility of antidiabetic medications in affecting changes in physical and cognitive functioning among older Mexican Americans diabetic patients over a 2-year period. METHODS: The existing cohort of Mexican Americans 60 or older in the Sacramento Area Latino Study on Aging (SALSA) Project was used. Physical functioning status was measured by assessment of Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). Cognitive functioning was measured by the Modified Mini Mental State Exam (3MS) and Delayed Word-list Recall Test. A generalized estimating equation (GEE) was used for data analysis. RESULTS: A total of 718 diabetic subjects in SALSA were divided into two groups (based on the duration of diabetes) to examine the effect of antidiabetic medications. For subjects with diagnosed diabetes less-than-or-equals, slant 5 years (N = 381), physical functioning improved over a two-year follow-up among subjects on treatment, compared to those without treatment, when controlling for diabetic symptoms (ADL: mean in log SCALE = −0.05, 95% CI = −0.10, −0.003). For subjects with diagnosed diabetes of 5+ years (N = 337), a significant increase in cognitive score and improvement in physical functioning were observed over a two-year follow-up among subjects on active treatments (N = 222), compared to those without treatment (N = 115) (3MS: MEAN = 6.64, 95% CI = 3.23, 10.05, ADL: mean in log SCALE = −0.10, 95% CI = −0.16, −0.04). Combination therapy of two or more antidiabetic agents appeared to be more effective than monotherapy in preventing the decline in physical and cognitive functioning for subjects. CONCLUSION: Antidiabetic drugs appear to be useful in alleviating the decline in physical and cognitive functioning among older Mexican Americans with diabetes, especially for those with a longer duration of the disease.