Title | Type 2 diabetes and cognitive decline over 14 years in middle-aged African Americans and whites: the ARIC Brain MRI Study. |
Publication Type | Journal Article |
Year of Publication | 2014 |
Authors | Mayeda ER, Haan MN, Neuhaus J, Yaffe K, Knopman DS, Sharrett ARichey, Griswold ME |
Secondary Authors | Mosley TH |
Journal | Neuroepidemiology |
Volume | 43 |
Issue | 3-4 |
Pagination | 220-7 |
Date Published | 2014 |
ISSN | 1423-0208 |
Keywords | African Americans, Aged, Cognition Disorders, Diabetes Mellitus, Type 2, European Continental Ancestry Group, Female, Humans, Incidence, Male, Memory, Middle Aged, Neuropsychological Tests, Prevalence, Risk Factors |
Abstract | BACKGROUND: Diabetes predicts late-life dementia, but the association with rate of cognitive decline is inconsistent and has rarely been examined in non-white populations, despite the high prevalence of diabetes in African Americans. We evaluated the effect of diabetes on cognitive decline in middle-aged African Americans and whites. METHODS: Atherosclerosis Risk in Communities (ARIC) Brain MRI Study participants (n = 1,886, mean age = 60, 49% African American) underwent assessments of verbal memory, processing speed, and verbal fluency four times over 14 years. Using race-stratified mixed linear effects models, we examined cognitive change for participants with prevalent (baseline) diabetes and incident (diagnosed after baseline) diabetes versus those without diabetes. RESULTS: African Americans had more advanced diabetes, as indicated by fasting blood glucose levels, anti-diabetes medication use, and cardiovascular risk profiles. African Americans with prevalent diabetes experienced 41% greater annual decline in processing speed scores (p = 0.048) and 50% greater annual decline in verbal fluency scores (p = 0.042) than those without diabetes; incident diabetes was not associated with cognitive decline. Among whites, diabetes was not associated with cognitive decline. CONCLUSIONS: Prevalent diabetes was associated with greater cognitive decline in middle-aged African Americans, possibly reflecting adverse effects of longer duration and more advanced diabetes. |
DOI | 10.1159/000366506 |
Alternate Journal | Neuroepidemiology |
PubMed ID | 25402639 |
PubMed Central ID | PMC4370220 |
Grant List | HHSN268201100012C / HL / NHLBI NIH HHS / United States HHSN268201100009I / HL / NHLBI NIH HHS / United States HL096899 / HL / NHLBI NIH HHS / United States U01 HL096812 / HL / NHLBI NIH HHS / United States K24-AG031155 / AG / NIA NIH HHS / United States HHSN268201100010C / HL / NHLBI NIH HHS / United States HL096902 / HL / NHLBI NIH HHS / United States HHSN268201100008C / HL / NHLBI NIH HHS / United States HHSN268201100005G / HL / NHLBI NIH HHS / United States U01 HL096917 / HL / NHLBI NIH HHS / United States HHSN268201100008I / HL / NHLBI NIH HHS / United States HHSN268201100005C / / PHS HHS / United States HHSN268201100007C / HL / NHLBI NIH HHS / United States HL096917 / HL / NHLBI NIH HHS / United States HHSN268201100009C / / PHS HHS / United States HHSN268201100011I / HL / NHLBI NIH HHS / United States HHSN268201100011C / HL / NHLBI NIH HHS / United States U01 HL096902 / HL / NHLBI NIH HHS / United States HHSN268201100010C / / PHS HHS / United States HHSN268201100006C / HL / NHLBI NIH HHS / United States K24 AG031155 / AG / NIA NIH HHS / United States HHSN268201100008C / / PHS HHS / United States R01-HL70825 / HL / NHLBI NIH HHS / United States HHSN268201100012C / / PHS HHS / United States AG-12975 / AG / NIA NIH HHS / United States HL096814 / HL / NHLBI NIH HHS / United States HHSN268201100005I / HL / NHLBI NIH HHS / United States U01 HL096814 / HL / NHLBI NIH HHS / United States HHSN268201100007C / / PHS HHS / United States R01 AG012975 / AG / NIA NIH HHS / United States HHSN268201100009C / HL / NHLBI NIH HHS / United States R01 HL070825 / HL / NHLBI NIH HHS / United States HHSN268201100011C / / PHS HHS / United States HHSN268201100005C / HL / NHLBI NIH HHS / United States U01 HL096899 / HL / NHLBI NIH HHS / United States HHSN268201100007I / HL / NHLBI NIH HHS / United States HHSN268201100006C / / PHS HHS / United States |