Relationships between cerebral structure and cognitive function in African Americans with type 2 diabetes |
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Authors: | Timothy M. Hughes Kaycee M. Sink Jeff D. Williamson Christina E. Hugenschmidt Benjamin C. Wagner Christopher T. Whitlow Jianzhao Xu S. Carrie Smith Lenore J. Launer Joshua I. Barzilay Faramarz Ismail-Beigi R. Nick Bryan Fang-Chi Hsu Donald W. Bowden Joseph A. Maldjian Jasmin Divers Barry I. Freedman |
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Affiliation: | 1. Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA;2. Department of Radiology, Advanced Neuroscience Imaging Research (ANSIR) Laboratory, University of Texas Southwestern Medical Center, Dallas, TX, USA;3. Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, USA;4. Departments of Biochemistry & Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, NC, USA;5. National Institutes of Health, National Institute on Aging, Laboratory of Epidemiology, Demography, and Biometry, Bethesda, MD, USA;6. Kaiser Permanente, Atlanta, GA, USA;g. Department of Internal Medicine, Division of Endocrinology, University of Cincinnati, Veterans Administration Medical Center, Cincinnati, OH;h. Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA;i. Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA;j. Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC, USA |
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Abstract: | BackgroundRelationships between cognitive function and brain structure remain poorly defined in African Americans with type 2 diabetes.MethodsCognitive testing and cerebral magnetic resonance imaging in African Americans from the Diabetes Heart Study Memory IN Diabetes (n?=?480) and Action to Control Cardiovascular Risk in Diabetes MIND (n?=?104) studies were examined for associations. Cerebral gray matter volume (GMV), white matter volume (WMV) and white matter lesion volume (WMLV) and cognitive performance (Mini-mental State Exam [MMSE and 3MSE], Digit Symbol Coding (DSC), Stroop test, and Rey Auditory Verbal Learning Test) were recorded. Multivariable models adjusted for age, sex, BMI, scanner, intracranial volume, education, diabetes duration, HbA1c, LDL-cholesterol, smoking, hypertension and cardiovascular disease assessed associations between cognitive tests and brain volumes by study and meta-analysis.ResultsMean(SD) participant age was 60.1(7.9) years, diabetes duration 12.1(7.7) years, and HbA1c 8.3(1.7)%. In the fully-adjusted meta-analysis, lower GMV associated with poorer global performance on MMSE/3MSE (?=?7.1?×?10?3, SE 2.4?×?10?3, p?=?3.6?×?10?3), higher WMLV associated with poorer performance on DSC (?=??3?×?10?2, SE 6.4?×?10?3, p?=?5.2?×?10?5) and higher WMV associated with poorer MMSE/3MSE performance (?=??7.1?×?10?3, SE?=?2.4?×?10?3, p?=?3.6?×?10?3).ConclusionsIn African Americans with diabetes, smaller GMV and increased WMLV associated with poorer performance on tests of global cognitive and executive function. These data suggest that WML burden and gray matter atrophy associate with cognitive performance independent of diabetes-related factors in this population. |
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Keywords: | African American Diabetes Brain Cognitive performance Magnetic resonance imaging |
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