Cognitive dysfunction is increasingly recognized as an important comorbidity of diabetes mellitus. Different stages of diabetes-associated cognitive dysfunction exist, each with different cognitive features, affected age groups and prognoses and probably with different underlying mechanisms. Relatively subtle, slowly progressive cognitive decrements occur in all age groups. More severe stages, particularly mild cognitive impairment and dementia, with progressive deficits, occur primarily in older individuals (>65 years of age). Patients in the latter group are the most relevant for patient management and are the focus of this Review. Here, we review the evolving insights from studies on risk factors, brain imaging and neuropathology, which provide important clues on mechanisms of both the subtle cognitive decrements and the more severe stages of cognitive dysfunction. In the majority of patients, the cognitive phenotype is probably defined by multiple aetiologies. Although both the risk of clinically diagnosed Alzheimer disease and that of vascular dementia is increased in association with diabetes, the cerebral burden of the prototypical pathologies of Alzheimer disease (such as neurofibrillary tangles and neuritic plaques) is not. A major challenge for researchers is to pinpoint from the spectrum of diabetes-related disease processes those that affect the brain and contribute to development of dementia beyond the pathologies of Alzheimer disease. Observations from experimental models can help to meet that challenge, but this requires further improving the synergy between experimental and clinical scientists. The development of targeted treatment and preventive strategies will therefore depend on these translational efforts.

To examine the extent to which Type 2 diabetes mellitus (T2DM) is associated with impairments in executive function (EF).Medline, PsychoInfo, and Scopus databases and published references were used to identify articles examining the association between T2DM status (case versus control) and EF decrements. Results from studies were converted to standardized mean differences and compared using random-effects models. Moderator analysis was conducted for age, sex, and diabetes duration using maximum likelihood estimation.Sixty studies (59 articles) including 9815 individuals with T2DM and 69,254 controls were included. Findings indicated a small but reliable association between T2DM status and EF decrements (d = -0.248, p <.001), observed across all aspects of EF examined: verbal fluency, mental flexibility, inhibition, working memory, and attention. Disease duration significantly moderated the effect of T2DM status on EF.T2DM is associated with a mild-to-moderate EF decrements. Such decrements are stronger among those with shorter disease duration.

In the classic Stroop effect, naming the color of an incompatible color word (e.g. the word RED printed in green ink; say, 'green') is much slower and more error-prone than is naming the color of a control item (e.g. XXX or CAT printed in green; say 'green'). This seemingly simple interference phenomenon has long provided a fertile testing ground for theories of the cognitive and neural components of selective attention. We present a sketch of the behavioral phenomenon, focusing on the idea that the relative automaticity of the two dimensions determines the direction and the degree of interdimensional interference between them. We then present an outline of current parallel processing explanations that instantiate this automaticity account, and we show how existing interference data are captured by such models. We also consider how Stroop facilitation (faster response of 'red' to RED printed in red) can be understood. Along the way, we describe research on two tasks that have emerged from the basic Stroop phenomenon - negative priming and the emotional Stroop task. Finally, we provide a survey of brain imaging research, highlighting the possible roles of the anterior cingulate in maintaining attentional set and in processing conflict or competition situations.

Initially described as task-induced deactivations during goal-directed paradigms of high attentional load, the unresolved functionality of default mode regions has long been assumed to interfere with task performance. However, recent evidence suggests a potential default mode network involvement in fulfilling cognitive demands. We tested this hypothesis in a finger opposition paradigm with task and fixation periods which we compared with an independent resting state scan using functional magnetic resonance imaging and a comprehensive analysis pipeline including activation, functional connectivity, behavioural and graph theoretical assessments. The results indicate task specific changes in the default mode network topography. Behaviourally, we show that increased connectivity of the posterior cingulate cortex with the left superior frontal gyrus predicts faster reaction times. Moreover, interactive and dynamic reconfiguration of the default mode network regions' functional connections illustrates their involvement with the task at hand with higher-level global parallel processing power, yet preserved small-world architecture in comparison with rest. These findings demonstrate that the default mode network does not disengage during this paradigm, but instead may be involved in task relevant processing. Copyright © 2015 Elsevier Inc. All rights reserved.