title: The influence of subclinical cardiovascular disease and related risk factors on cognition in type 2 diabetes mellitus: The DHS-Mind study.
abstract: We hypothesized that measures of coronary artery calcified plaque (CAC) collected at baseline from the Diabetes Heart Study (DHS) would explain associations between cognition and diabetes collected at follow-up approximately 7 years later. The DHS is a sibling study of cardiovascular disease (CVD) in a cohort with a high prevalence of type 2 diabetes (~80%). Associations between baseline CAC and cognitive performance were tested using generalized estimating equations and mixed effects models to adjust for familial relationships. Diabetes status was associated (p<0.05) with poorer performance on tests of verbal memory, processing speed, and semantic fluency adjusting for age, sex, education, and hypertension status. As hypothesized, including CAC in the statistical model attenuated this association. Additionally, CAC and fasting glucose predicted performance in tasks not associated with diabetes status in this study (Stroop Task, Phonemic Fluency). These results confirm work attributing the heterogeneity of cognitive outcomes in type 2 diabetes to subclinical risk factors that combine to affect different aspects of brain function. Importantly, these results imply that risk factor intervention should begin before comorbidities, particularly CVD, become clinically apparent.
authors: Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA. Electronic address: chugensc@wakehealth.edu.
authors: Christina E
authors: CE
authors: Hugenschmidt
authors: Fang-Chi
authors: FC
authors: Hsu
authors: Satoru
authors: S
authors: Hayasaka
authors: J Jeffrey
authors: JJ
authors: Carr
authors: Barry I
authors: BI
authors: Freedman
authors: David L
authors: DL
authors: Nyenhuis
authors: Jeff D
authors: JD
authors: Williamson
authors: Donald W
authors: DW
authors: Bowden
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology; D003071:Cognition; D003072:Cognition Disorders / Q000453:epidemiology*; D003324:Coronary Artery Disease / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D058226:Plaque, Atherosclerotic / Q000453:epidemiology* / Q000473:pathology; D015995:Prevalence; D012307:Risk Factors
keywords: Atherosclerosis; Cardiovascular disease; Cognition; Type 2 diabetes
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