title: Ethnicity/culture modulates the relationships of the haptoglobin (Hp) 1-1 phenotype with cognitive function in older individuals with type 2 diabetes.
abstract: OBJECTIVE
  The haptoglobin (Hp) genotype has been associated with cognitive function in type 2 diabetes. Because ethnicity/culture has been associated with both cognitive function and Hp genotype frequencies, we examined whether it modulates the association of Hp with cognitive function.
  
  
  METHODS
  This cross-sectional study evaluated 787 cognitively normal older individuals (>65 years of age) with type 2 diabetes participating in the Israel Diabetes and Cognitive Decline study. Interactions in two-way analyses of covariance compared Group (Non-Ashkenazi versus Ashkenazi Jews) on the associations of Hp phenotype (Hp 1-1 versus non- Hp 1-1) with five cognitive outcome measures. The primary control variables were age, gender, and education.
  
  
  RESULTS
  Compared with Ashkenazi Jews, non-Ashkenazi Jews with the Hp 1-1 phenotype had significantly poorer cognitive function than non-Hp 1-1 in the domains of Attention/Working Memory (p = 0.035) and Executive Function (p = 0.023), but not in Language/Semantic Categorization (p = 0.432), Episodic Memory (p = 0.268), or Overall Cognition (p = 0.082). After controlling for additional covariates (type 2 diabetes-related characteristics, cardiovascular risk factors, Mini-mental State Examination, and extent of depressive symptoms), Attention/Working Memory (p = 0.038) and Executive Function (p = 0.013) remained significant.
  
  
  CONCLUSIONS
  Older individuals from specific ethnic/cultural backgrounds with the Hp 1-1 phenotype may benefit more from treatment targeted at decreasing or halting the detrimental effects of Hp 1-1 on the brain. Future studies should examine differential associations of Hp 1-1 and cognitive impairment, especially for groups with high prevalence of both, such as African-Americans and Hispanics.
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.|James J. Peters Veterans Affairs Medical Center, Bronx, NY, 10468, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Guerrero-Berroa
authors.affiliation: The Joseph Sagol Neuroscience Center, Sheba Medical Center, Ramat Gan, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ramit
authors.initials: R
authors.lastname: Ravona-Springer
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.|Maccabi Healthcare Services, Tel Aviv, Israel.
authors.forename: Anthony
authors.initials: A
authors.lastname: Heymann
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
authors.forename: James
authors.initials: J
authors.lastname: Schmeidler
authors.affiliation: Maccabi Healthcare Services, Tel Aviv, Israel.
authors.forename: Hadas
authors.initials: H
authors.lastname: Hoffman
authors.affiliation: Maccabi Healthcare Services, Tel Aviv, Israel.
authors.forename: Rachel
authors.initials: R
authors.lastname: Preiss
authors.affiliation: The Joseph Sagol Neuroscience Center, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Keren
authors.initials: K
authors.lastname: Koifmann
authors.affiliation: The Joseph Sagol Neuroscience Center, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Lior
authors.initials: L
authors.lastname: Greenbaum
authors.affiliation: Technion Faculty of Medicine, Technion Israel Institute of Technology, Technion, Haifa, Israel.
authors.forename: Andrew
authors.initials: A
authors.lastname: Levy
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.|James J. Peters Veterans Affairs Medical Center, Bronx, NY, 10468, USA.
authors.forename: Jeremy M
authors.initials: JM
authors.lastname: Silverman
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
authors.forename: Derek
authors.initials: D
authors.lastname: Leroith
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.|James J. Peters Veterans Affairs Medical Center, Bronx, NY, 10468, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Sano
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.|The Joseph Sagol Neuroscience Center, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Michal
authors.initials: M
authors.lastname: Schnaider-Beeri
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001288:Attention / Q000502:physiology; D003071:Cognition / Q000502:physiology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000208:ethnology / Q000235:genetics / Q000503:physiopathology; D056344:Executive Function / Q000502:physiology; D005260:Female; D005838:Genotype; D006242:Haptoglobins / Q000235:genetics*; D006801:Humans; D007585:Jews; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology; D008875:Middle Aged; D010641:Phenotype; D012737:Sex Factors
chemical_list: D006242:Haptoglobins
keywords: cognitive domains; cognitive function; diabetes; ethnicity/culture; haptoglobin; older adults