Association of diabetes severity with cognitive function in US adults: a cross-sectional analysis of the AI-READI multicentre cohort

OBJECTIVES: To evaluate whether type 2 diabetes mellitus (T2DM) presence and severity are associated with differences in global and domain-specific cognitive function among US adults, using standardised Montreal Cognitive Assessment (MoCA) testing. DESIGN: Cross-sectional study SETTING: Three U.S academic medical centres participating in the Artificial Intelligence-Ready and Equitable Atlas for Diabetes Insights (AI-READI) study. PARTICIPANTS: Adults aged ≥40 years enrolled in the AI-READI cross-sectional study at three US academic medical centres were eligible. The study excluded individuals with type 1 diabetes, pregnancy or inability to speak, read and understand English. For this secondary analysis, 1067 participants from the first publicly released AI-READI data set who had MoCA data and assigned glycaemic status were included. Participants were classified into four prespecified glycaemic groups: controls without diabetes (n=371), pre-diabetes (n=239), medication-controlled type 2 diabetes (n=323), and insulin-dependent type 2 diabetes (n=129). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was global cognitive function measured by the MoCA total score. Secondary outcomes included MoCA domain scores and the prevalence of cognitive impairment, defined as MoCA