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.
Christine M. Robertson
JOANNE MORLING JOANNE.MORLING@NOTTINGHAM.AC.UK
Clinician Scientist Fellowin Public Health
Brian M. Frier
Ian J. Deary
Mark W.J. Strachan
Jackie F. Price
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|
|Peer Reviewed||Peer Reviewed|
|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|
|Keywords||Blood glucose; Blood pressure; Cardiovascular risk ; Cholesterol; Cognitive impairment ; Glycaemic control; Hyperglycaemia; Older age; Smoking ; Type 2 diabetes|
|Copyright Statement||Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0|
Feinkohl 2015 Diabetologia.pdf
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0