Diabetes, markers of brain pathology and cognitive function: The Age, Gene/Environment Susceptibility-Reykjavik Study

Chengxuan Qiu, Sigurdur Sigurdsson, Qian Zhang, Maria K. Jonsdottir, Olafur Kjartansson, Gudny Eiriksdottir, Melissa E. Garcia, Tamara B. Harris, Mark A. Van Buchem, Vilmundur Gudnason, Lenore J. Launer

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Abstract

Objective We investigated whether, and the extent to which, vascular and degenerative lesions in the brain mediate the association of diabetes with poor cognitive performance. Methods This cross-sectional study included 4,206 participants (age > 65 years; 57.8% women) of the Age, Gene/Environment Susceptibility-Reykjavik Study. Data were collected through interview, clinical examination, psychological testing, and laboratory tests. The composite scores on memory, information-processing speed, and executive function were derived from a cognitive test battery. Markers of cerebral macrovascular (cortical infarcts), microvascular (subcortical infarcts, cerebral microbleeds, and higher white matter lesion volume), and neurodegenerative (lower gray matter, normal white matter, and total brain tissue volumes) processes were assessed on magnetic resonance images. Mediation models were employed to test the mediating effect of brain lesions on the association of diabetes with cognitive performance controlling for potential confounders. Results There were 462 (11.0%) persons with diabetes. Diabetes was significantly associated with lower scores on processing speed and executive function, but not with memory function. Diabetes was significantly associated with all markers of brain pathology. All of these markers were significantly associated with lower scores on memory, processing speed, and executive function. Formal mediation tests suggested that markers of cerebrovascular and degenerative pathology significantly mediated the associations of diabetes with processing speed and executive function. Interpretation Diabetes is associated with poor performance on cognitive tests of information-processing speed and executive function. The association is largely mediated by markers of both neurodegeneration and cerebrovascular disease. Older people with diabetes should be monitored for cognitive problems and brain lesions. Ann Neurol 2014;75:138-146

Original languageEnglish
Pages (from-to)138-146
Number of pages9
JournalAnnals of Neurology
Volume75
Issue number1
DOIs
Publication statusPublished - Jan 2014
Externally publishedYes

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ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Qiu, C., Sigurdsson, S., Zhang, Q., Jonsdottir, M. K., Kjartansson, O., Eiriksdottir, G., Garcia, M. E., Harris, T. B., Van Buchem, M. A., Gudnason, V., & Launer, L. J. (2014). Diabetes, markers of brain pathology and cognitive function: The Age, Gene/Environment Susceptibility-Reykjavik Study. Annals of Neurology, 75(1), 138-146. https://doi.org/10.1002/ana.24063