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

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.

Authors

Insa Feinkohl

Markéta Keller

Christine M. Robertson

JOANNE MORLING JOANNE.MORLING@NOTTINGHAM.AC.UK
Clinician Scientist Fellowin Public Health

Stela McLachlan

Brian M. Frier

Ian J. Deary

Mark W.J. Strachan

Jackie F. Price



Abstract

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, HbA1c, 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 HbA1c (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 HbA1c and historical BP emerged as significant independent predictors of 4 year decline in g (standardised beta range -0.07 to -0.14; all p

Journal Article Type Article
Publication Date Jul 31, 2015
Journal Diabetologia
Print ISSN 0012-186X
Electronic ISSN 1432-0428
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 58
Issue 7
APA6 Citation Feinkohl, I., Keller, M., Robertson, C. M., Morling, J. R., McLachlan, S., Frier, B. M., …Price, J. F. (2015). Cardiovascular risk factors and cognitive decline in older people with type 2 diabetes. Diabetologia, 58(7), https://doi.org/10.1007/s00125-015-3581-0
DOI https://doi.org/10.1007/s00125-015-3581-0
Keywords Blood glucose; Blood pressure; Cardiovascular risk ; Cholesterol; Cognitive impairment ; Glycaemic control; Hyperglycaemia; Older age; Smoking ; Type 2 diabetes
Publisher URL https://link.springer.com/article/10.1007%2Fs00125-015-3581-0
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0





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