Diabetes affects mortality and cognitive functioning. It is not known how diabetes influences life expectancy (LE) with or without cognitive impairment. The study set out to examine age at onset of cognitive impairment and life expectancy (LE) with or without cognitive impairment by diabetes status among middle- and older-aged Americans. The results of the study indicates that older adults with diabetes have a higher chance of cognitive impairment and a shorter life expectancy compared with those without. A recent estimate suggests that diabetes is associated with a 40% increase in the odds of dementia among older Americans. The precise physiologic pathways linking diabetes and cognitive impairment remain largely undetermined. Given that cognitive impairment is a major cause of loss of independence, presents a barrier to medication adherence and results in extremely high care costs, policies aimed at improving outcomes among those with diabetes should be informed by the level of cognitive impairment in this population. Researchers studied age at onset of cognitive impairment and life expectancy with and without cognitive impairment by diabetes status among middle- and older-aged adults. The total sample included 13,687 individuals aged 50 to 74 years who contributed 136,367 person-years of follow-up from 2000 to 2012. They calculated age at onset of cognitive impairment and life expectancy with and without cognitive impairment by diabetes status at age 50 years. The results show diabetes as a strong indicator of increased mortality and cognitive decline. For men and women, and for most ages, those with diabetes had a higher prevalence of cognitive impairment than those without. The researchers found that the average cognition score for people with diabetes was 1.7 points lower and the prevalence of cognitive impairment was more than 10% higher compared with those without diabetes (25% vs. 14%; P .01).  From age 50 years, men and women with diabetes had a first incidence of cognitive impairment 3 and 4 years earlier, respectively, than those without diabetes. Diabetes decreased total life expectancy by 5 to 7 years and cognitively healthy life expectancy by 4 to 6 years. Compared with individuals without diabetes, those with diabetes lived approximately 1 year less with poor cognitive health. Furthermore, although education was strongly protective of cognitive health, diabetes was linked to lower age at cognitive impairment onset and fewer cognitive healthy years lived across all educational groups.  Diaz-Venegas C, et al. PLOS One. 2017;doi:10.1371/journal.pone.0190488, January 5, 2018.