Nadia Ramsingh, Hung-Mo Lin, Yuxia Ouyang, Ramit Ravona-Springer, Abigail Livny, Laili Soleimani, Barbara B. Bendlin, Mery Ben Meir, Anthony Heymann, Mary Sano, Joseph Azuri, Michal Schnaider Beeri
{"title":"自评健康状况差与 2 型糖尿病老年人认知能力下降速度加快和小血管疾病增多有关","authors":"Nadia Ramsingh, Hung-Mo Lin, Yuxia Ouyang, Ramit Ravona-Springer, Abigail Livny, Laili Soleimani, Barbara B. Bendlin, Mery Ben Meir, Anthony Heymann, Mary Sano, Joseph Azuri, Michal Schnaider Beeri","doi":"10.1002/dmrr.3761","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>Self-rated health (SRH) is a predictor for poor health outcomes and cognition. Older adults with type 2 diabetes mellitus (T2D) have multi-morbidity and greater cognitive impairment. In the present study we investigated the association of SRH with cognitive decline and brain pathology in older adults with T2D.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Participants (<i>n</i> = 1122) were from the Israel Diabetes and Cognitive Decline study, and SRH was categorised as low (<i>n</i> = 202), moderate (<i>n</i> = 400) or high (<i>n</i> = 520). Cognition was measured by four cognitive domains: episodic memory, executive functions, language, and attention/working memory. Global cognition was the average of the cognitive domains. Statistical models adjusted for sociodemographic, cardiovascular, and clinical variables. In a randomly selected subsample (<i>n</i> = 230) that had magnetic resonance imaging, we examined relationships between baseline SRH and brain characteristics (white matter hyperintensities [WMHs], hippocampal, and total grey matter [GM] volumes).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Low SRH was associated with a decline in executive functions, which accelerated over time when compared to high SRH (est = −0.0036; <i>p</i> = <0.001). Compared to high SRH, low SRH was associated with a faster decline in global cognition (est = −0.0024; <i>p</i> = 0.009). Low SRH at baseline was associated with higher volumes of WMHs (est = 9.8420; <i>p</i> < 0.0008). SRH was not associated with other cognitive domains, or with hippocampal and total GM.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Low SRH is associated with cognitive decline in T2D older adults and may serve as a risk assessment. WMHs may represent an underlying mechanism.</p>\n </section>\n </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"40 1","pages":""},"PeriodicalIF":4.6000,"publicationDate":"2024-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.3761","citationCount":"0","resultStr":"{\"title\":\"Poor self-rated health is associated with faster cognitive decline and greater small vessel disease in older adults with type 2 diabetes\",\"authors\":\"Nadia Ramsingh, Hung-Mo Lin, Yuxia Ouyang, Ramit Ravona-Springer, Abigail Livny, Laili Soleimani, Barbara B. Bendlin, Mery Ben Meir, Anthony Heymann, Mary Sano, Joseph Azuri, Michal Schnaider Beeri\",\"doi\":\"10.1002/dmrr.3761\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>Self-rated health (SRH) is a predictor for poor health outcomes and cognition. Older adults with type 2 diabetes mellitus (T2D) have multi-morbidity and greater cognitive impairment. In the present study we investigated the association of SRH with cognitive decline and brain pathology in older adults with T2D.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Participants (<i>n</i> = 1122) were from the Israel Diabetes and Cognitive Decline study, and SRH was categorised as low (<i>n</i> = 202), moderate (<i>n</i> = 400) or high (<i>n</i> = 520). Cognition was measured by four cognitive domains: episodic memory, executive functions, language, and attention/working memory. Global cognition was the average of the cognitive domains. Statistical models adjusted for sociodemographic, cardiovascular, and clinical variables. In a randomly selected subsample (<i>n</i> = 230) that had magnetic resonance imaging, we examined relationships between baseline SRH and brain characteristics (white matter hyperintensities [WMHs], hippocampal, and total grey matter [GM] volumes).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Low SRH was associated with a decline in executive functions, which accelerated over time when compared to high SRH (est = −0.0036; <i>p</i> = <0.001). Compared to high SRH, low SRH was associated with a faster decline in global cognition (est = −0.0024; <i>p</i> = 0.009). Low SRH at baseline was associated with higher volumes of WMHs (est = 9.8420; <i>p</i> < 0.0008). 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Poor self-rated health is associated with faster cognitive decline and greater small vessel disease in older adults with type 2 diabetes
Objective
Self-rated health (SRH) is a predictor for poor health outcomes and cognition. Older adults with type 2 diabetes mellitus (T2D) have multi-morbidity and greater cognitive impairment. In the present study we investigated the association of SRH with cognitive decline and brain pathology in older adults with T2D.
Methods
Participants (n = 1122) were from the Israel Diabetes and Cognitive Decline study, and SRH was categorised as low (n = 202), moderate (n = 400) or high (n = 520). Cognition was measured by four cognitive domains: episodic memory, executive functions, language, and attention/working memory. Global cognition was the average of the cognitive domains. Statistical models adjusted for sociodemographic, cardiovascular, and clinical variables. In a randomly selected subsample (n = 230) that had magnetic resonance imaging, we examined relationships between baseline SRH and brain characteristics (white matter hyperintensities [WMHs], hippocampal, and total grey matter [GM] volumes).
Results
Low SRH was associated with a decline in executive functions, which accelerated over time when compared to high SRH (est = −0.0036; p = <0.001). Compared to high SRH, low SRH was associated with a faster decline in global cognition (est = −0.0024; p = 0.009). Low SRH at baseline was associated with higher volumes of WMHs (est = 9.8420; p < 0.0008). SRH was not associated with other cognitive domains, or with hippocampal and total GM.
Conclusions
Low SRH is associated with cognitive decline in T2D older adults and may serve as a risk assessment. WMHs may represent an underlying mechanism.
期刊介绍：
Diabetes/Metabolism Research and Reviews is a premier endocrinology and metabolism journal esteemed by clinicians and researchers alike. Encompassing a wide spectrum of topics including diabetes, endocrinology, metabolism, and obesity, the journal eagerly accepts submissions ranging from clinical studies to basic and translational research, as well as reviews exploring historical progress, controversial issues, and prominent opinions in the field. Join us in advancing knowledge and understanding in the realm of diabetes and metabolism.
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