title: Ankle-brachial index and inter-artery blood pressure differences as predictors of cognitive function in overweight and obese older adults with diabetes: results from the Action for Health in Diabetes movement and memory study.
abstract: OBJECTIVE
  Ankle-brachial index (ABI) and interartery systolic blood pressure differences, as markers of vascular disease, are plausible risk factors for deficits in cognitive function among overweight and obese adults with type 2 diabetes.
  
  
  METHODS
  The ABI and maximum interartery differences (MIAD) in systolic blood pressures were assessed annually for five years among 479 participants assigned to the control condition in a randomized clinical trial of a behavioral weight loss intervention. A battery of standardized cognitive function tests was administered 4 to 5 years later. Analyses of covariance were used to assess relationships that ABI, MIAD, and progression of ABI and MIAD had with cognitive function.
  
  
  RESULTS
  There was a curvilinear relationship between ABI and a composite index of cognitive function (p = 0.03), with lower ABI being associated with poorer function. In graded fashions, both greater MIAD and increases in MIAD over time also had modest relationships with poorer verbal memory (both p ≤ 0.05), processing speed (both p ≤ 0.05), and composite cognitive function (both p < 0.04). These relationships were independent of each other and remained evident after extensive covariate adjustment.
  
  
  CONCLUSIONS
  In overweight and obese adults with type 2 diabetes, lower ABI and larger interartery systolic blood pressure differences have modest, independent, graded relationships with poorer cognitive function 4-5 years later.
authors.affiliation: Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Espeland
authors.affiliation: Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Beavers
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Bethany Barone
authors.initials: BB
authors.lastname: Gibbs
authors.affiliation: University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: Karen C
authors.initials: KC
authors.lastname: Johnson
authors.affiliation: Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Hughes
authors.affiliation: Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Laura D
authors.initials: LD
authors.lastname: Baker
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: John
authors.initials: J
authors.lastname: Jakicic
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Korytkowski
authors.affiliation: University of Colorado Health Science Center, Aurora, CO, USA.
authors.forename: Marsha
authors.initials: M
authors.lastname: Miller
authors.affiliation: Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA.
authors.forename: George A
authors.initials: GA
authors.lastname: Bray
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D055109:Ankle Brachial Index; D001794:Blood Pressure / Q000502:physiology*; D003071:Cognition / Q000502:physiology*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology; D050177:Overweight / Q000150:complications / Q000503:physiopathology*; D012307:Risk Factors
keywords: arterial disease; cognitive function; diabetes; obesity