Relationships between cerebral structure and cognitive function in African Americans with type 2 diabetes

AA-DHS MIND and ACCORD MIND Investigators

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Relationships between cognitive function and brain structure remain poorly defined in African Americans with type 2 diabetes. Methods: Cognitive 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. Results: Mean(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 (β̂ = 7.1 × 10−3, SE 2.4 × 10−3, p = 3.6 × 10−3), higher WMLV associated with poorer performance on DSC (β̂ = −3 × 10−2, SE 6.4 × 10−3, p = 5.2 × 10−5) and higher WMV associated with poorer MMSE/3MSE performance (β̂ = −7.1 × 10−3, SE = 2.4 × 10−3, p = 3.6 × 10−3). Conclusions: In 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.

Original languageEnglish (US)
JournalJournal of Diabetes and its Complications
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

African Americans
Type 2 Diabetes Mellitus
Cognition
Meta-Analysis
Stroop Test
Verbal Learning
Executive Function
Brain
LDL Cholesterol
Atrophy
Cardiovascular Diseases
Smoking
Magnetic Resonance Imaging
White Matter
Hypertension
Education
Gray Matter
Population

Keywords

  • African American
  • Brain
  • Cognitive performance
  • Diabetes
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Relationships between cerebral structure and cognitive function in African Americans with type 2 diabetes. / AA-DHS MIND and ACCORD MIND Investigators.

In: Journal of Diabetes and its Complications, 01.01.2018.

Research output: Contribution to journalArticle

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abstract = "Background: Relationships between cognitive function and brain structure remain poorly defined in African Americans with type 2 diabetes. Methods: Cognitive 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. Results: Mean(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 (β̂ = 7.1 × 10−3, SE 2.4 × 10−3, p = 3.6 × 10−3), higher WMLV associated with poorer performance on DSC (β̂ = −3 × 10−2, SE 6.4 × 10−3, p = 5.2 × 10−5) and higher WMV associated with poorer MMSE/3MSE performance (β̂ = −7.1 × 10−3, SE = 2.4 × 10−3, p = 3.6 × 10−3). Conclusions: In 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.",
keywords = "African American, Brain, Cognitive performance, Diabetes, Magnetic resonance imaging",
author = "{AA-DHS MIND and ACCORD MIND Investigators} and Hughes, {Timothy M.} and Sink, {Kaycee M.} and Williamson, {Jeff D.} and Hugenschmidt, {Christina E.} and Wagner, {Benjamin C.} and Whitlow, {Christopher T.} and Jianzhao Xu and Smith, {S. Carrie} and Launer, {Lenore J.} and Barzilay, {Joshua I.} and Faramarz Ismail-Beigi and Bryan, {R. Nick} and Hsu, {Fang Chi} and Bowden, {Donald W.} and Maldjian, {Joseph A} and Jasmin Divers and Freedman, {Barry I.}",
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AU - AA-DHS MIND and ACCORD MIND Investigators

AU - Hughes, Timothy M.

AU - Sink, Kaycee M.

AU - Williamson, Jeff D.

AU - Hugenschmidt, Christina E.

AU - Wagner, Benjamin C.

AU - Whitlow, Christopher T.

AU - Xu, Jianzhao

AU - Smith, S. Carrie

AU - Launer, Lenore J.

AU - Barzilay, Joshua I.

AU - Ismail-Beigi, Faramarz

AU - Bryan, R. Nick

AU - Hsu, Fang Chi

AU - Bowden, Donald W.

AU - Maldjian, Joseph A

AU - Divers, Jasmin

AU - Freedman, Barry I.

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N2 - Background: Relationships between cognitive function and brain structure remain poorly defined in African Americans with type 2 diabetes. Methods: Cognitive 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. Results: Mean(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 (β̂ = 7.1 × 10−3, SE 2.4 × 10−3, p = 3.6 × 10−3), higher WMLV associated with poorer performance on DSC (β̂ = −3 × 10−2, SE 6.4 × 10−3, p = 5.2 × 10−5) and higher WMV associated with poorer MMSE/3MSE performance (β̂ = −7.1 × 10−3, SE = 2.4 × 10−3, p = 3.6 × 10−3). Conclusions: In 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.

AB - Background: Relationships between cognitive function and brain structure remain poorly defined in African Americans with type 2 diabetes. Methods: Cognitive 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. Results: Mean(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 (β̂ = 7.1 × 10−3, SE 2.4 × 10−3, p = 3.6 × 10−3), higher WMLV associated with poorer performance on DSC (β̂ = −3 × 10−2, SE 6.4 × 10−3, p = 5.2 × 10−5) and higher WMV associated with poorer MMSE/3MSE performance (β̂ = −7.1 × 10−3, SE = 2.4 × 10−3, p = 3.6 × 10−3). Conclusions: In 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.

KW - African American

KW - Brain

KW - Cognitive performance

KW - Diabetes

KW - Magnetic resonance imaging

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