Clinically Relevant Cognitive Impairment in Middle-Aged Adults With Childhood-Onset Type 1 Diabetes
| Autor: | Christopher M. Ryan, Rachel L. Miller, Tina Costacou, Robert M. Boudreau, Karen A. Nunley, Trevor J. Orchard, Howard J. Aizenstein, Janice C. Zgibor, J. Richard Jennings, Caterina Rosano, Judith Saxton |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Research design medicine.medical_specialty Pediatrics Adolescent Endocrinology Diabetes and Metabolism Disease Neuropsychological Tests Severity of Illness Index Vascular health Cognition Risk Factors Diabetes mellitus Odds Ratio Internal Medicine medicine Humans Age of Onset Pathophysiology/Complications Cognitive impairment Aged Aged 80 and over Advanced and Specialized Nursing Type 1 diabetes e-Letters: Comments and Responses business.industry Odds ratio Middle Aged medicine.disease Diabetes Mellitus Type 1 Cohort Physical therapy Female Cognition Disorders business Follow-Up Studies |
| Zdroj: | Diabetes Care |
| ISSN: | 1935-5548 0149-5992 |
| Popis: | OBJECTIVE The aim of this study was to investigate the presence and correlates of clinically relevant cognitive impairment in middle-aged adults with childhood-onset type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS During 2010–2013, 97 adults diagnosed with T1D and aged RESULTS The prevalence of clinically relevant cognitive impairment was five times higher among participants with than without T1D (28% vs. 5%; P < 0.0001), independent of education, age, or blood pressure. Effect sizes were large (Cohen d 0.6–0.9; P < 0.0001) for psychomotor speed and visuoconstruction tasks and were modest (d 0.3–0.6; P < 0.05) for measures of executive function. Among participants with T1D, prevalent cognitive impairment was related to 14-year average A1c >7.5% (58 mmol/mol) (odds ratio [OR] 3.0; P = 0.009), proliferative retinopathy (OR 2.8; P = 0.01), and distal symmetric polyneuropathy (OR 2.6; P = 0.03) measured 5 years earlier; higher BMI (OR 1.1; P = 0.03); and ankle-brachial index ≥1.3 (OR 4.2; P = 0.01) measured 20 years earlier, independent of education. CONCLUSIONS Clinically relevant cognitive impairment is highly prevalent among these middle-aged adults with childhood-onset T1D. In this aging cohort, chronic hyperglycemia and prevalent microvascular disease were associated with cognitive impairment, relationships shown previously in younger populations with T1D. Two additional potentially modifiable risk factors for T1D-related cognitive impairment, vascular health and BMI, deserve further study. |
| Databáze: | OpenAIRE |
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