The population is aging in the United States as well as worldwide. The prevalence of diabetes increases with increasing age. To provide optimal care to older adults with diabetes, unique psychosocial barriers need to be considered by medical providers. Unlike in younger adults, cognitive dysfunction/dementia and depressive mood disorders are common coexisting conditions in older adults with diabetes. This article reviews recent literature on epidemiology and clinical implications of cognitive and psychosocial dysfunctions in older patients with diabetes. This article focuses on cognitive dysfunctions, dementia, depression, and other psychosocial stresses, and their implications in the care of older adults with diabetes.