Diabetes, markers of brain pathology and cognitive function: the Age, Gene/Environment Susceptibility-Reykjavik Study.
Diabetes, markers of brain pathology and cognitive function: the Age, Gene/Environment Susceptibility-Reykjavik Study.
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DOI：
10.1002/ana.24063
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发表时间：
2014-01
影响因子：
11.2
通讯作者：
Launer LJ
中科院分区：
文献类型：
--
作者：
Qiu C;Sigurdsson S;Zhang Q;Jonsdottir MK;Kjartansson O;Eiriksdottir G;Garcia ME;Harris TB;van Buchem MA;Gudnason V;Launer LJ
我们研究了大脑中的血管和退行性病变是否以及在多大程度上介导了糖尿病与认知能力差的关联。这项横断面研究包括年龄、基因/环境易感性-雷克雅未克研究的 4,206 名参与者（年龄 >65 岁；57.8% 为女性）。通过访谈、临床检查、心理测试和实验室测试收集数据。记忆力、信息处理速度和执行功能的综合得分来自认知测试组。通过磁共振图像评估脑大血管（皮质梗塞）、微血管（皮质下梗塞、脑微出血和较高的白质病变体积）和神经退行性病变（较低的灰质、正常白质和总脑组织体积）过程的标记物。采用中介模型来测试脑损伤对糖尿病与控制潜在混杂因素的认知表现之间的关联的中介作用。糖尿病患者 462 人（11.0%）。糖尿病与处理速度和执行功能的较低分数显着相关，但与记忆功能无关。糖尿病与脑病理学的所有标志物显着相关。所有这些标记都与记忆力、处理速度和执行功能的较低分数显着相关。正式的中介测试表明，脑血管和退行性病理学标志物显着介导了糖尿病与处理速度和执行功能的关联。糖尿病与信息处理速度和执行功能的认知测试表现不佳有关。这种关联主要是由神经退行性变和脑血管疾病的标志物介导的。应监测老年糖尿病患者的认知问题和脑部病变。
We investigated whether, and the extent to which, vascular and degenerative lesions in the brain mediate the association of diabetes with poor cognitive performance. 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. 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. 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.