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Cardiovascular risk factors and cognitive decline in older people with type 2 diabetes

Aims/hypothesis The aim of this work was to assess the role of well-established cardiovascular risk factors in the late-life cognitive decline of patients with type 2 diabetes. Methods Data from 831 participants (aged 60–75 years) attending the 4 year follow-up of the Edinburgh Type 2 Diabetes Study... Full description

Journal Title: Diabetologia 2015-04-07, Vol.58 (7), p.1637-1645
Main Author: Feinkohl, Insa
Other Authors: Keller, Markéta , Robertson, Christine M , Morling, Joanne R , McLachlan, Stela , Frier, Brian M , Deary, Ian J , Strachan, Mark W. J , Price, Jackie F
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Berlin/Heidelberg: Springer Berlin Heidelberg
ID: ISSN: 0012-186X
Link: https://www.ncbi.nlm.nih.gov/pubmed/25847351
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recordid: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4473016
title: Cardiovascular risk factors and cognitive decline in older people with type 2 diabetes
format: Article
creator:
  • Feinkohl, Insa
  • Keller, Markéta
  • Robertson, Christine M
  • Morling, Joanne R
  • McLachlan, Stela
  • Frier, Brian M
  • Deary, Ian J
  • Strachan, Mark W. J
  • Price, Jackie F
subjects:
  • Aged
  • Article
  • Blood glucose
  • Blood Glucose - analysis
  • Blood Pressure
  • Blood sugar
  • Cardiovascular diseases
  • Cardiovascular Diseases - epidemiology
  • Cardiovascular Diseases - etiology
  • Cardiovascular risk
  • Cholesterol
  • Cholesterol - blood
  • Cognition Disorders - epidemiology
  • Cognition Disorders - etiology
  • Cognition Disorders - psychology
  • Cognitive impairment
  • Diabetes
  • Diabetes Mellitus, Type 2 - complications
  • Diabetes Mellitus, Type 2 - epidemiology
  • Diabetes Mellitus, Type 2 - psychology
  • Endocrinology
  • Female
  • Follow-Up Studies
  • Glycaemic control
  • Glycated Hemoglobin A - analysis
  • Human Physiology
  • Humans
  • Hyperglycaemia
  • Hyperglycemia
  • Internal Medicine
  • Male
  • Medicine
  • Medicine & Public Health
  • Metabolic Diseases
  • Metabolism
  • Middle Aged
  • Neuropsychological Tests
  • Older age
  • Resveratrol
  • Risk Factors
  • Scotland - epidemiology
  • Smoking
  • Smoking - adverse effects
  • Smoking - epidemiology
  • Type 2 diabetes
ispartof: Diabetologia, 2015-04-07, Vol.58 (7), p.1637-1645
description: Aims/hypothesis The aim of this work was to assess the role of well-established cardiovascular risk factors in the late-life cognitive decline of patients with type 2 diabetes. Methods Data from 831 participants (aged 60–75 years) attending the 4 year follow-up of the Edinburgh Type 2 Diabetes Study (ET2DS) were used. Smoking history (pack-years), BP, HbA 1c , plasma glucose and cholesterol were determined at baseline clinics (single time measurements) and/or from serial data recorded on a clinical management database from diagnosis until recruitment (‘historical’ data). Principal component analysis derived a factor, g , of general ability from seven cognitive tests. Linear regression models of follow-up g were adjusted for baseline g to represent 4 year cognitive change. ‘Accelerated late-life cognitive decline’ was defined as scoring in the lowest tertile of ‘4 year cognitive change’ regression scores. Analyses controlled for age and sex. Results A baseline history of moderate/heavy smoking (≥10 pack-years) and a 1% increased historical HbA 1c (equivalent to an increase by 11 mmol/mol) predicted a 64% (OR 1.64; 95% CI 1.14, 2.34; p  = 0.007) and 21% (OR 1.21; 95% CI 1.00, 1.45; p  = 0.046) increased risk of accelerated cognitive decline, respectively. When treated as continuous measures, higher pack-years, historical HbA 1c and historical BP emerged as significant independent predictors of 4 year decline in g (standardised β range −0.07 to −0.14; all p  ≤ 0.05). Conclusions/interpretation Increased smoking and poorer glycaemic control (with relatively weaker findings for BP) during the life-course were independently associated with accelerated late-life cognitive decline. Where possible, evaluation is warranted of these risk factors as targets for intervention to reduce the burden of cognitive impairment in diabetes.
language: eng
source:
identifier: ISSN: 0012-186X
fulltext: no_fulltext
issn:
  • 0012-186X
  • 1432-0428
url: Link


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titleCardiovascular risk factors and cognitive decline in older people with type 2 diabetes
creatorFeinkohl, Insa ; Keller, Markéta ; Robertson, Christine M ; Morling, Joanne R ; McLachlan, Stela ; Frier, Brian M ; Deary, Ian J ; Strachan, Mark W. J ; Price, Jackie F
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descriptionAims/hypothesis The aim of this work was to assess the role of well-established cardiovascular risk factors in the late-life cognitive decline of patients with type 2 diabetes. Methods Data from 831 participants (aged 60–75 years) attending the 4 year follow-up of the Edinburgh Type 2 Diabetes Study (ET2DS) were used. Smoking history (pack-years), BP, HbA 1c , plasma glucose and cholesterol were determined at baseline clinics (single time measurements) and/or from serial data recorded on a clinical management database from diagnosis until recruitment (‘historical’ data). Principal component analysis derived a factor, g , of general ability from seven cognitive tests. Linear regression models of follow-up g were adjusted for baseline g to represent 4 year cognitive change. ‘Accelerated late-life cognitive decline’ was defined as scoring in the lowest tertile of ‘4 year cognitive change’ regression scores. Analyses controlled for age and sex. Results A baseline history of moderate/heavy smoking (≥10 pack-years) and a 1% increased historical HbA 1c (equivalent to an increase by 11 mmol/mol) predicted a 64% (OR 1.64; 95% CI 1.14, 2.34; p  = 0.007) and 21% (OR 1.21; 95% CI 1.00, 1.45; p  = 0.046) increased risk of accelerated cognitive decline, respectively. When treated as continuous measures, higher pack-years, historical HbA 1c and historical BP emerged as significant independent predictors of 4 year decline in g (standardised β range −0.07 to −0.14; all p  ≤ 0.05). Conclusions/interpretation Increased smoking and poorer glycaemic control (with relatively weaker findings for BP) during the life-course were independently associated with accelerated late-life cognitive decline. Where possible, evaluation is warranted of these risk factors as targets for intervention to reduce the burden of cognitive impairment in diabetes.
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subjectAged ; Article ; Blood glucose ; Blood Glucose - analysis ; Blood Pressure ; Blood sugar ; Cardiovascular diseases ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - etiology ; Cardiovascular risk ; Cholesterol ; Cholesterol - blood ; Cognition Disorders - epidemiology ; Cognition Disorders - etiology ; Cognition Disorders - psychology ; Cognitive impairment ; Diabetes ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetes Mellitus, Type 2 - psychology ; Endocrinology ; Female ; Follow-Up Studies ; Glycaemic control ; Glycated Hemoglobin A - analysis ; Human Physiology ; Humans ; Hyperglycaemia ; Hyperglycemia ; Internal Medicine ; Male ; Medicine ; Medicine & Public Health ; Metabolic Diseases ; Metabolism ; Middle Aged ; Neuropsychological Tests ; Older age ; Resveratrol ; Risk Factors ; Scotland - epidemiology ; Smoking ; Smoking - adverse effects ; Smoking - epidemiology ; Type 2 diabetes
ispartofDiabetologia, 2015-04-07, Vol.58 (7), p.1637-1645
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descriptionAims/hypothesis The aim of this work was to assess the role of well-established cardiovascular risk factors in the late-life cognitive decline of patients with type 2 diabetes. Methods Data from 831 participants (aged 60–75 years) attending the 4 year follow-up of the Edinburgh Type 2 Diabetes Study (ET2DS) were used. Smoking history (pack-years), BP, HbA 1c , plasma glucose and cholesterol were determined at baseline clinics (single time measurements) and/or from serial data recorded on a clinical management database from diagnosis until recruitment (‘historical’ data). Principal component analysis derived a factor, g , of general ability from seven cognitive tests. Linear regression models of follow-up g were adjusted for baseline g to represent 4 year cognitive change. ‘Accelerated late-life cognitive decline’ was defined as scoring in the lowest tertile of ‘4 year cognitive change’ regression scores. Analyses controlled for age and sex. Results A baseline history of moderate/heavy smoking (≥10 pack-years) and a 1% increased historical HbA 1c (equivalent to an increase by 11 mmol/mol) predicted a 64% (OR 1.64; 95% CI 1.14, 2.34; p  = 0.007) and 21% (OR 1.21; 95% CI 1.00, 1.45; p  = 0.046) increased risk of accelerated cognitive decline, respectively. When treated as continuous measures, higher pack-years, historical HbA 1c and historical BP emerged as significant independent predictors of 4 year decline in g (standardised β range −0.07 to −0.14; all p  ≤ 0.05). Conclusions/interpretation Increased smoking and poorer glycaemic control (with relatively weaker findings for BP) during the life-course were independently associated with accelerated late-life cognitive decline. Where possible, evaluation is warranted of these risk factors as targets for intervention to reduce the burden of cognitive impairment in diabetes.
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18Diabetes Mellitus, Type 2 - epidemiology
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authorFeinkohl, Insa ; Keller, Markéta ; Robertson, Christine M ; Morling, Joanne R ; McLachlan, Stela ; Frier, Brian M ; Deary, Ian J ; Strachan, Mark W. J ; Price, Jackie F
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abstractAims/hypothesis The aim of this work was to assess the role of well-established cardiovascular risk factors in the late-life cognitive decline of patients with type 2 diabetes. Methods Data from 831 participants (aged 60–75 years) attending the 4 year follow-up of the Edinburgh Type 2 Diabetes Study (ET2DS) were used. Smoking history (pack-years), BP, HbA 1c , plasma glucose and cholesterol were determined at baseline clinics (single time measurements) and/or from serial data recorded on a clinical management database from diagnosis until recruitment (‘historical’ data). Principal component analysis derived a factor, g , of general ability from seven cognitive tests. Linear regression models of follow-up g were adjusted for baseline g to represent 4 year cognitive change. ‘Accelerated late-life cognitive decline’ was defined as scoring in the lowest tertile of ‘4 year cognitive change’ regression scores. Analyses controlled for age and sex. Results A baseline history of moderate/heavy smoking (≥10 pack-years) and a 1% increased historical HbA 1c (equivalent to an increase by 11 mmol/mol) predicted a 64% (OR 1.64; 95% CI 1.14, 2.34; p  = 0.007) and 21% (OR 1.21; 95% CI 1.00, 1.45; p  = 0.046) increased risk of accelerated cognitive decline, respectively. When treated as continuous measures, higher pack-years, historical HbA 1c and historical BP emerged as significant independent predictors of 4 year decline in g (standardised β range −0.07 to −0.14; all p  ≤ 0.05). Conclusions/interpretation Increased smoking and poorer glycaemic control (with relatively weaker findings for BP) during the life-course were independently associated with accelerated late-life cognitive decline. Where possible, evaluation is warranted of these risk factors as targets for intervention to reduce the burden of cognitive impairment in diabetes.
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