Urine Test May Help Detect Risk of Cognitive Decline in Type 2 Diabetics

The risk for future cognitive decline in people with type 2 diabetes can be detected by the presence of protein in urine, suggests a latest finding.

For those suffering with diabetes, urine tests are a part of routine checkups as they help detect the presence of albumin (protein) in the urine as well as the level of protein present. A greater cognitive decline was noticed in diabetics with persistent protein levels in the urine for over four to five years compared to those without albumin in their urine. Though this decline is hardly noticeable it can translate to an evident impairment after 10 to 15 years. This new study states that urinary protein levels can be an early warning sign.

The study was conducted by Joshua Barzilay, MD (Kaiser Permanente of Georgia/Emory School of Medicine), Lenore Launer, PhD (National Institute on Aging).

In this study the researchers tried to evaluate whether albuminuria,  a kidney complication common in diabetics  characterized by protein excretion in urine, can be an early indicator  for cognitive decline in older diabetes victims.

The study analyzed data of 2977 diabetes with the average age 62 collected between 2003-2005. The subjects were followed until 2009. At the beginning of the study, the subjects were made to undergo three neuropsychological tests that included verbal memory, information processing speed and execution function. The same was repeated at 20 and 40 months.

On analyzing the data the researchers noticed a great decline in information processing speed in people with persistent albuminuria over four to five years compared to subjects without albuminuria. Persistent and progressive albuminuria was associated with more than 5 percent reduction in information processing speed scores. This was not similar in verbal memory and executive function performance.

"Our finding was a subtle change in cognition; however, were this decline to continue over 10 to 15 years it could translate into noticeable cognitive decline by the age of 75 to 80 years, when cognitive impairment generally becomes clinically evident," said Dr. Barzilay. "Given how common albuminuria and diabetes are in the older population, these findings have a great deal of importance from a population point of view. Moreover, albuminuria is also common among older people with hypertension without diabetes."

The study will be published in an upcoming Clinical Journal of the American Society of Nephrology (CJASN).