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Heterogeneous Trajectories of Cognitive Function in Older Adults with Diabetes: Findings from the Korean Longitudinal Study of Aging (KLoSA)
Korean J Stress Res 2019;27:1-8
Published online March 31, 2019
© 2019 Korean Society of Stress Medicine.

Chanhee Kim1 , Min Jung Kim2 , Chang Gi Park2

1서울대학교 간호과학연구소,
2일리노이 주립대학교 시카고 캠퍼스 간호대학
Correspondence to: Min Jung Kim College of Nursing, The University of Illinois at Chicago, 845 S. Damen Ave., Chicago, IL 60612, USA Tel: +1-217-420-4909 Fax: +1-312-996-8945 E-mail:
Received February 11, 2019; Revised March 6, 2019; Accepted March 6, 2019.
Articles published in stress are open-access, distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Given the rapidly aging population and increasing diabetes prevalence in Korea and worldwide, maintaining optimal cognitive function is a concern in older adults with diabetes. This study aimed to identify heterogeneous trajectories of cognitive function in older adults with diabetes based on the Mini-Mental State Examination and characterize these trajectories.


Study participants consisted of 672 community-dwelling Korean older adults with diabetes, and data were obtained from the population-based Korean Longitudinal Study of Aging from 2006 through 2016. Growth mixture modeling (GMM) was employed to identify distinct trajectories of cognitive function in older adults with diabetes.


We found that older adults with diabetes followed five distinct cognitive function trajectories over 10 years: normal-maintained (41.5%), normal-declined (23.8%), mildly impaired-maintained (17.1%), mildly impaired-declined (11.2%), and severely impaired-declined (6.4%). Also, we found that age, gender, household income, and self-rated health status at baseline were associated with these trajectories.


Our identification and characterization of heterogeneous cognitive function trajectories in older adults with diabetes have significant implications for developing tailored interventions to older adults with diabetes, specifically to whom at heightened risk for cognitive decline and consequent deterioration in essential diabetes self-management activities.

Keywords : Cognition, Diabetes, Elderly

June 2019, 27 (2)

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