Author ORCID Identifier

Date of Award

Spring 5-1-2024

Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Dr. Ike Okosun

Second Advisor

Dr. Elizabeth Armstrong-Mensah


INTRODUCTION: Diabetes has been classified as one of the leading preventable risk factors for cognitive decline and further progression to dementia. Approximately 40% of all dementia cases can theoretically be prevented or at least delayed if certain risk factors in subjects with diabetes are eliminated. If risk factors for dementia in individuals with diabetes are targeted, it will lead to a decrease in the number of people with cognitive decline, and further reduce the prevalence of dementia in the coming years.

AIM: This study aims to investigate risk factors associated with cognitive decline in subjects with diabetes. METHODS: The study analyzed data from the Behavioral Risk Factor Surveillance System using a sample of 1,913 individuals with diabetes. We determined the association between various risk factors such as gender, BMI, physical activity, race/ethnicity, marital status, satisfaction with life, inability to afford a doctor, and depressive disorder diagnosis in subjects with diabetes. Odds ratios from the multivariable logistic regression models were used to estimate the degree of association. Statistical significance was established using 95% confidence intervals or p-value < 0.05.

RESULTS: Regular physical activity (OR = 0.70, 95% CI: 0.52 – 0.94, P = 0.018) and satisfaction with life (OR = 0.70, 95% CI: 0.52 – 0.94, P = 0.018) were associated with reduced odds for dementia. Individuals with a depressive disorder and those ‘unable to afford to see a doctor’ had 1.59 and 1.97 higher odds of dementia than those who had no depression and could afford to see a doctor. Also, males had 7% reduced odds of dementia, and overweight or obese people had 1.35 higher odds for dementia. Moreover, non-Hispanic White individuals had higher odds of dementia compared to non-Hispanic Black and Hispanic individuals, and married people had reduced odds compared to divorced, ‘never married,’ and widowed people. Unemployed individuals and those earning good income had higher odds of dementia than individuals who were employed for wages or self-employed and individuals earning low income.

CONCLUSION: These findings are crucial in terms of public health and call for public health practitioners to be aware of risk factors for cognitive decline and dementia in diabetes patients. Public health interventions can help reduce the prevalence of cognitive decline in diabetes patients by promoting physical activity, improving diet, and encouraging cognitively stimulating activities such as reading and social engagement.


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