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

20 Scopus citations

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
Volume43
Issue number3-4
DOIs
StatePublished - Apr 16 2014

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Keywords

  • Cognitive decline
  • Diabetes
  • Epidemiology
  • Ethnicity

ASJC Scopus subject areas

  • Epidemiology
  • Clinical Neurology

Cite this

Mayeda, E. R., Haan, M. N., Neuhaus, J., Yaffe, K., Knopman, D. S., Sharrett, A. R., Griswold, M. E., & Mosley, T. H. (2014). Type 2 diabetes and cognitive decline over 14 years in middle-aged African Americans and whites: The ARIC brain MRI study. Neuroepidemiology, 43(3-4), 220-227. https://doi.org/10.1159/000366506