Impact of antidiabetic medications on physical and cognitive functioning of older Mexican Americans with diabetes mellitus: A population based cohort study

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 with diabetes over a 2-year period. METHODS: A longitudinal analysis with repeated measurements between 1999 and 2001 was performed in a cohort of Mexican Americans, 60 or older, in the SALSA Project. Statistical analysis was conducted using a generalized estimating equation. RESULTS: For subjects with diagnosed diabetes less than or equal to 5 years (N = 381), there was less decline in physical and cognitive functioning over 2 years among subjects on treatment, compared to those without treatment. For subjects with diagnosed diabetes of 5+ years (N = 337), the effect of antidiabetic medications was more significant in preventing the decline in physical and cognitive functioning (ADL: mean in log scale = -0.10, 95% CI = -0.16, -0.04, 3MS: mean = 6.35, 95% CI = 3.23, 9.48). Combination therapy of antidiabetic agents appeared to be more effective than monotherapy in preventing the decline in physical and cognitive functioning for subjects. CONCLUSIONS: 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. (C) 2003 Elsevier Inc. All rights reserved.