title: Diabetes is associated with cerebrovascular but not Alzheimer's disease neuropathology.
abstract: The relationship of diabetes to specific neuropathologic causes of dementia is incompletely understood.
  
  
  
  We used logistic regression to evaluate the association between diabetes and infarcts, Braak neurofibrillary tangle stage, and neuritic plaque score in 2365 autopsied persons. In a subset of >1300 persons with available cognitive data, we examined the association between diabetes and cognition using Poisson regression.
  
  
  
  Diabetes increased odds of brain infarcts (odds ratio [OR] = 1.57, P < .0001), specifically lacunes (OR = 1.71, P < .0001), but not Alzheimer's disease neuropathology. Diabetes plus infarcts was associated with lower cognitive scores at end of life than infarcts or diabetes alone, and diabetes plus high level of Alzheimer's neuropathologic changes was associated with lower mini-mental state examination scores than the pathology alone.
  
  
  
  This study supports the conclusions that diabetes increases the risk of cerebrovascular but not Alzheimer's disease pathology, and at least some of diabetes' relationship to cognitive impairment may be modified by neuropathology.
authors.affiliation: Sanders-Brown Center on Aging and Alzheimer's Disease Center, University of Kentucky, Lexington, KY, USA; College of Public Health, Department of Epidemiology, University of Kentucky, Lexington, KY, USA; College of Public Health, Department of Biostatistics, University of Kentucky, Lexington, KY, USA. Electronic address: erin.abner@uky.edu.
authors.forename: Erin L
authors.initials: EL
authors.lastname: Abner
authors.affiliation: Sanders-Brown Center on Aging and Alzheimer's Disease Center, University of Kentucky, Lexington, KY, USA; College of Medicine, Department of Pathology, University of Kentucky, Lexington, KY, USA.
authors.forename: Peter T
authors.initials: PT
authors.lastname: Nelson
authors.affiliation: Sanders-Brown Center on Aging and Alzheimer's Disease Center, University of Kentucky, Lexington, KY, USA; College of Public Health, Department of Biostatistics, University of Kentucky, Lexington, KY, USA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Kryscio
authors.affiliation: Sanders-Brown Center on Aging and Alzheimer's Disease Center, University of Kentucky, Lexington, KY, USA; College of Medicine, Department of Neurology, University of Kentucky, Lexington, KY, USA.
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Schmitt
authors.affiliation: Sanders-Brown Center on Aging and Alzheimer's Disease Center, University of Kentucky, Lexington, KY, USA; College of Public Health, Department of Biostatistics, University of Kentucky, Lexington, KY, USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Fardo
authors.affiliation: Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA; School of Medicine, Department of Pathology, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Randall L
authors.initials: RL
authors.lastname: Woltjer
authors.affiliation: Knight Alzheimer's Disease Research Center, Washington University, St. Louis, MO, USA; School of Medicine, Department of Neurology, Washington University, St. Louis, MO, USA.
authors.forename: Nigel J
authors.initials: NJ
authors.lastname: Cairns
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Rush University Medical Center, Department of Neurological Sciences, Chicago, IL, USA.
authors.forename: Lei
authors.initials: L
authors.lastname: Yu
authors.affiliation: Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA; School of Medicine, Department of Neurology, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Hiroko H
authors.initials: HH
authors.lastname: Dodge
authors.affiliation: Knight Alzheimer's Disease Research Center, Washington University, St. Louis, MO, USA; School of Medicine, Division of Biostatistics, Washington University, St. Louis, MO, USA.
authors.forename: Chengjie
authors.initials: C
authors.lastname: Xiong
authors.affiliation: Kuakini Medical Center and John A. Burns School of Medicine, Department of Geriatric Medicine, University of Hawaii, Honolulu, HI, USA.
authors.forename: Kamal
authors.initials: K
authors.lastname: Masaki
authors.affiliation: School of Public Health and Health Systems, Department of Psychology, University of Waterloo, Waterloo, ON, Canada.
authors.forename: Suzanne L
authors.initials: SL
authors.lastname: Tyas
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Rush University Medical Center, Department of Neurological Sciences, Chicago, IL, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Bennett
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Rush University Medical Center, Department of Pathology, Chicago, IL, USA.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Schneider
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Rush University Medical Center, Department of Neurological Sciences, Chicago, IL, USA.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Arvanitakis
mesh_terms: D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology*; D000818:Animals; D001344:Autopsy; D001921:Brain / Q000473:pathology*; D020520:Brain Infarction / Q000209:etiology / Q000473:pathology; D003072:Cognition Disorders / Q000209:etiology; D015331:Cohort Studies; D048909:Diabetes Complications / Q000473:pathology / Q000503:physiopathology; D003920:Diabetes Mellitus / Q000473:pathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008609:Mental Status Schedule; D016874:Neurofibrillary Tangles / Q000473:pathology*; D009483:Neuropsychological Tests
keywords: Alzheimer; Autopsy; Cerebrovascular; Cognition; Diabetes; Infarcts; Neuropathology
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