The mediating role of comorbid conditions in the association between type 2 diabetes and cognition: a cross-sectional observational study using the UK Biobank cohort
Whitelock, Victoria, Rutters, Femke, Rijnhart, Judith J. M., Nouwen, Arie ORCID: https://orcid.org/0000-0002-0609-4082 and Higgs, Suzanne
(2021)
The mediating role of comorbid conditions in the association between type 2 diabetes and cognition: a cross-sectional observational study using the UK Biobank cohort.
Psychoneuroendocrinology, 123
, 104902.
ISSN 0306‐4530
[Article]
(doi:10.1016/j.psyneuen.2020.104902)
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Abstract
Aims: Using the UK Biobank cohort, a large sample of middle aged and older adults in the UK, the present study aimed to examine the cross-sectional association between type 2 diabetes and cognition and to assess the hypothesised mediating role of common comorbid conditions, whilst controlling for important demographic and lifestyle factors.
Methods: Using regression models and general structural equation models, we examined the cross-sectional association between type 2 diabetes status and: fluid intelligence; reaction time; visual memory; digit span and prospective memory; and the hypothesised mediating role of common comorbid conditions: visceral obesity; sleep problems; macrovascular problems; respiratory problems,; cancer and depressive symptoms in 47,468 participants from the UK Biobank cohort, of whom 1,831 have type 2 diabetes. We controlled for ethnicity, sex, age, deprivation, smoking status, alcohol consumption, physical activity levels and use of diabetes medication.
Results: Participants with type 2 diabetes had a significantly shorter digit span, b = -0.14, 99.2% CIs [-0.27, -0.11] than those without type 2 diabetes. Those with type 2 diabetes did not differ from those without type 2 diabetes on fluid intelligence, reaction time, visual memory and prospective memory. The associations that do exist between type 2 diabetes and cognition are consistently mediated via macrovascular problems, depressive symptoms, and to a lesser extent visceral obesity. Respiratory problems, sleep disturbances and cancer did not mediate the association between type 2 diabetes status and measures of cognition.
Conclusions: Comorbid conditions explain some of the observed association between type 2 diabetes and cognitive deficits. This suggests that prevention, management or treatment of these comorbid conditions may be important to reduce the likelihood of cognitive decline. Treatment studies with long follow-ups are needed to examine this.
Tweet: Comorbid conditions explain the association between type 2 diabetes and cognitive deficits. Prevention, management or treatment of these comorbid conditions may prevent or delay the onset of cognitive decline in people with type 2 diabetes.
Item Type: | Article |
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Research Areas: | A. > School of Science and Technology > Psychology |
Item ID: | 31041 |
Notes on copyright: | Published version: © 2020 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
Useful Links: | |
Depositing User: | Arie Nouwen |
Date Deposited: | 25 Sep 2020 15:44 |
Last Modified: | 29 Nov 2022 18:05 |
URI: | https://eprints.mdx.ac.uk/id/eprint/31041 |
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