Type 2 Diabetes and Cognitive Decline Over 14 Years in Middle-Aged African Americans and Whites

The ARIC Brain MRI Study

Elizabeth R. Mayeda, Mary N. Haan, John Neuhaus, Kristine Yaffe, David S Knopman, A. Richey Sharrett, Michael E. Griswold, Thomas H. Mosley

Research output: Contribution to journalArticle

18 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)220-227
Number of pages8
JournalNeuroepidemiology
DOIs
StateAccepted/In press - Nov 13 2014

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African Americans
Type 2 Diabetes Mellitus
Atherosclerosis
Brain
Dementia
Blood Glucose
Cognitive Dysfunction
Linear Models
Fasting
Population

ASJC Scopus subject areas

  • Epidemiology
  • Clinical Neurology

Cite this

Type 2 Diabetes and Cognitive Decline Over 14 Years in Middle-Aged African Americans and Whites : The ARIC Brain MRI Study. / Mayeda, Elizabeth R.; Haan, Mary N.; Neuhaus, John; Yaffe, Kristine; Knopman, David S; Sharrett, A. Richey; Griswold, Michael E.; Mosley, Thomas H.

In: Neuroepidemiology, 13.11.2014, p. 220-227.

Research output: Contribution to journalArticle

Mayeda, Elizabeth R. ; Haan, Mary N. ; Neuhaus, John ; Yaffe, Kristine ; Knopman, David S ; Sharrett, A. Richey ; Griswold, Michael E. ; Mosley, Thomas H. / Type 2 Diabetes and Cognitive Decline Over 14 Years in Middle-Aged African Americans and Whites : The ARIC Brain MRI Study. In: Neuroepidemiology. 2014 ; pp. 220-227.
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