Factors associated with cognitive impairment in patients with newly diagnosed type 2 diabetes: a cross-sectional study

Moulton, Calum D.; Stewart, Robert; Amiel, Stephanie A.; Laake, Jean-Pierre; Ismail, Khalida

doi:10.1080/13607863.2015.1040723

Cited by 21 publications

(16 citation statements)

References 31 publications

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“…Four studies were found to have critical risk of bias, meaning they were likely to be too biased to allow for any contribution to the research question. [ 26 ] All four studies were cross-sectional analyses, and in total accounted for less than 2,000 participants with diabetes from Australia, [ 28 ] Canada, [ 35 ] the UK, [ 42 ] and US. [ 31 ] There was no clear trend among these studies with respect to an association between depression and cognition.…”

Section: Resultsmentioning

confidence: 99%

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Association between Depressive Symptoms and Cognitive Function in Persons with Diabetes Mellitus: A Systematic Review

et al. 2016

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Depression and diabetes are independent risk factors for one another, and both are associated with increased risk of cognitive decline. Diabetes patients with lower cognitive function are more likely to suffer poorer health outcomes. However, the role of depression in cognitive decline among people with diabetes is not well understood. This systematic review assessed whether adults with comorbid diabetes and depression or depressive symptoms exhibit greater cognitive decline relative to individuals with diabetes alone. Searches were run in CINAHL, the Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO, and PubMed (MEDLINE) with no time or language restrictions. Studies were eligible for inclusion if they were of any quantitative study design, included participants aged 18 years or older with diabetes mellitus of which some must have presented with current depression, and measured cognition as an outcome. The Cochrane Collaboration’s Risk Of Bias In Non-randomized Studies–of Interventions tool was used for quality assessment of each study and its collected outcome. Fifteen articles were included in the final analysis. The high degree of heterogeneity in exposures, outcomes, and participant characteristics precluded a meta-analysis of any of the studies, and the risk of bias observed in these studies limits the strength of the evidence. Nonetheless, this review found the presence of comorbid depression was associated with poorer cognitive outcomes than for persons with diabetes alone. While large-scale preventive efforts must address epidemic levels of diabetes and its comorbidities, on the patient level healthcare professionals must be cognizant of the added difficulties that depression poses to patients and the extra support required to management diabetes in these cases. This systematic review is registered with the University of York Centre for Reviews and Dissemination under registration number 2015:CRD42015025122.

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Section: Resultsmentioning

confidence: 99%

“…[ 31 ] Similarly, another reported no relationship between depressive symptoms and TICS-M scores. [ 42 ] Lastly, one study found that reaction times were significantly faster among participants with comorbid depression–the only study out of fifteen to find a positive association between depression and cognition ( Table 3 ). [ 35 ]…”

Section: Resultsmentioning

confidence: 99%

Association between Depressive Symptoms and Cognitive Function in Persons with Diabetes Mellitus: A Systematic Review

et al. 2016

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“…Previous neuroimaging studies of T2DM patients show that brain atrophy appears in the hippocampus, amygdala, and prefrontal areas, and it frequently occurs in elderly patients with long duration of diabetes 23 . Cognitive impairment across multiple domains of cognition has been demonstrated in T2DM, and involve executive functioning, memory, attention, information processing and visuospatial abilities 24 – 27 , even in studies with middle-age T2DM patients 28 – 31 . In line with these cognitive dysfunctions, neuroimaging studies show the functional brain changes in early stage T2DM as well, including altered resting-state functional connectivity and task-related neuronal activity 32 – 35 .…”

Section: Introductionmentioning

confidence: 99%

Decision-making in primary onset middle-age type 2 diabetes mellitus: a BOLD-fMRI study

Sun

et al. 2017

Sci Rep

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Although type 2 diabetes mellitus (T2DM) is a well-recognized risk factor for dementia, the neural mechanisms that underlying cognitive impairment in T2DM remain unclear. We used functional magnetic resonance imaging (fMRI) during a computerized version of the Iowa Gambling Task to investigate the neural basis of decision making at the initial onset stage of T2DM. Eighteen newly diagnosed middle-aged T2DM patients, with no previous diabetic treatment history, and 18 matched controls were recruited. Results indicated that T2DM patients made more disadvantageous decisions than controls. Compared to healthy subjects, T2DM patients showed decreased activation in the ventral medial prefrontal cortex (VMPFC), orbitofrontal cortex (OFC) and anterior cingulate cortex, and increased activity in the dorsolateral prefrontal cortex, posterior cingulate cortex, insula and occipital lobes. IGT performance positively correlated with changes in brain activation in the VMPFC and OFC in both groups. Moreover, poor glycemic control was associated with decision-making function both in behavioral and brain activity in the VMPFC and OFC in patients. Conclusively, T2DM patients may suffer from weaknesses in their prefrontal cortex functions that lead to poorer decision-making under ambiguity, at least as assessed by the IGT.

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“…An explanation might be that though there have been reports on a positive association of high-normal glucose levels in diabetes-free subjects of the general population with hippocampal atrophy (Weinstein et al 2015 ), most studies indicate that these changes are primarily seen in those patients with longer disease duration and higher HbA1c levels (Ebady et al 2008 ; Lin et al 2013 ) and those with late sequelae such as micro- or macrovascular damage (Wessels et al 2006 , Moulton et al 2016 ) and peripheral neuropathy.…”

Section: Discussionmentioning

confidence: 99%

Early effects of a high-caloric diet and physical exercise on brain volumetry and behavior: a combined MRI and histology study in mice

Sack

Lenz

Jakovcevski

et al. 2016

Brain Imaging and Behavior

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Excessive intake of high-caloric diets as well as subsequent development of obesity and diabetes mellitus may exert a wide range of unfavorable effects on the central nervous system (CNS) in the long-term. The potentially harmful effects of such diets were suggested to be mitigated by physical exercise. Here, we conducted a study investigating early effects of a cafeteria-diet on gray and white brain matter volume by means of voxel-based morphometry (VBM) and region-of-interest (ROI) analysis. Half of the mice performed voluntary wheel running to study if regular physical exercise prevents unfavorable effects of a cafeteria-diet. In addition, histological analyses for myelination and neurogenesis were performed. As expected, wheel running resulted in a significant increase of gray matter volume in the CA1–3 areas, the dentate gyrus and stratum granulosum of the hippocampus in the VBM analysis, while a positive effect of the cafeteria-diet was shown for the whole hippocampal CA1–3 area only in the ROI analysis, indicating a regional volume effect. It was earlier found that hippocampal neurogenesis may be related to volume increases after exercise. Interestingly, while running resulted in a significant increase in neurogenesis assessed by doublecortin (DCX)-labeling, this was not true for cafeteria diet. This indicates different underlying mechanisms for gray matter increase. Moreover, animals receiving cafeteria diet only showed mild deficits in long-term memory assessed by the puzzle-box paradigm, while executive functioning and short term memory were not affected. Our data therefore highlight that high caloric diet impacts on the brain and behavior. Physical exercise seems not to interact with these mechanisms.

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Factors associated with cognitive impairment in patients with newly diagnosed type 2 diabetes: a cross-sectional study

Cited by 21 publications

References 31 publications

Association between Depressive Symptoms and Cognitive Function in Persons with Diabetes Mellitus: A Systematic Review

Association between Depressive Symptoms and Cognitive Function in Persons with Diabetes Mellitus: A Systematic Review

Decision-making in primary onset middle-age type 2 diabetes mellitus: a BOLD-fMRI study

Early effects of a high-caloric diet and physical exercise on brain volumetry and behavior: a combined MRI and histology study in mice

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