title: Associations between anxiety and depression symptoms and cognitive testing and neuroimaging in type 2 diabetes.
abstract: OBJECTIVE
  Anxiety, depression, accelerated cognitive decline, and increased risk of dementia are observed in individuals with type 2 diabetes. Anxiety and depression may contribute to lower performance on cognitive tests and differences in neuroimaging observed in individuals with type 2 diabetes.
  
  
  METHODS
  These relationships were assessed in 655 European Americans with type 2 diabetes from 504 Diabetes Heart Study families. Participants completed cognitive testing, brain magnetic resonance imaging, the Brief Symptom Inventory Anxiety subscale, and the Center for Epidemiologic Studies Depression-10.
  
  
  RESULTS
  In analyses adjusted for age, sex, educational attainment, and use of psychotropic medications, individuals with comorbid anxiety and depression symptoms had lower performance on all cognitive testing measures assessed (p≤0.005). Those with both anxiety and depression also had increased white matter lesion volume (p=0.015), decreased gray matter cerebral blood flow (p=4.43×10(-6)), decreased gray matter volume (p=0.002), increased white and gray matter mean diffusivity (p≤0.001), and decreased white matter fractional anisotropy (p=7.79×10(-4)). These associations were somewhat attenuated upon further adjustment for health status related covariates.
  
  
  CONCLUSIONS
  Comorbid anxiety and depression symptoms were associated with cognitive performance and brain structure in a European American cohort with type 2 diabetes.
authors.affiliation: Molecular Genetics and Genomics Program, Wake Forest School of Medicine, Winston-Salem, NC, USA; Center for Human Genomics, Wake Forest School of Medicine, Winston-Salem, NC, USA; Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Raffield
authors.affiliation: Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Gretchen A
authors.initials: GA
authors.lastname: Brenes
authors.affiliation: Center for Human Genomics, Wake Forest School of Medicine, Winston-Salem, NC, USA; Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Cox
authors.affiliation: Department of Internal Medicine - Nephrology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Barry I
authors.initials: BI
authors.lastname: Freedman
authors.affiliation: Department of Gerontology and Geriatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Christina E
authors.initials: CE
authors.lastname: Hugenschmidt
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Fang-Chi
authors.initials: FC
authors.lastname: Hsu
authors.affiliation: Center for Human Genomics, Wake Forest School of Medicine, Winston-Salem, NC, USA; Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Jianzhao
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Wagner
authors.affiliation: Department of Gerontology and Geriatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Jeff D
authors.initials: JD
authors.lastname: Williamson
authors.affiliation: Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Maldjian
authors.affiliation: Center for Human Genomics, Wake Forest School of Medicine, Winston-Salem, NC, USA; Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, USA. Electronic address: dbowden@wakehealth.edu.
authors.forename: Donald W
authors.initials: DW
authors.lastname: Bowden
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000150:complications / Q000453:epidemiology*; D001921:Brain / Q000098:blood supply / Q000473:pathology*; D002560:Cerebrovascular Circulation; D003072:Cognition Disorders / Q000150:complications / Q000453:epidemiology*; D015331:Cohort Studies; D003704:Dementia / Q000150:complications / Q000453:epidemiology*; D003863:Depression / Q000150:complications / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000473:pathology / Q000523:psychology*; D003925:Diabetic Angiopathies / Q000150:complications / Q000473:pathology / Q000523:psychology; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D009657:North Carolina / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors
keywords: Anxiety; Cognition; Depression; Magnetic resonance imaging; Type 2 diabetes