Diabetes Mellitus and Cognition Pathway Analysis in the MEMENTO Cohort

被引：28

作者：

Frison, Eric ^{[1
,2
,3
]}

Proust-Lima, Cecile ^{[1
]}

Mangin, Jean-Francois ^{[5
,6
]}

Habert, Marie-Odile ^{[5
,7
,8
]}

Bombois, Stephanie ^{[9
]}

Ousset, Pierre-Jean ^{[11
]}

Pasquier, Florence ^{[12
]}

Hanon, Olivier ^{[13
]}

Paquet, Claire ^{[14
]}

Gabelle, Audrey ^{[15
]}

Ceccaldi, Mathieu ^{[5
,16
,17
]}

Annweiler, Cedric ^{[18
,19
]}

Krolak-Salmon, Pierre ^{[20
]}

Bejot, Yannick ^{[21
]}

Belin, Catherine ^{[22
]}

Wallon, David ^{[23
]}

Sauvee, Mathilde ^{[24
]}

Beaufils, Emilie ^{[25
]}

Bourdel-Marchasson, Isabelle ^{[4
,26
]}

Jalenques, Isabelle ^{[27
]}

Chupin, Marie ^{[10
]}

Chene, Genevieve ^{[1
,2
,3
]}

Dufouil, Carole ^{[1
,2
,3
]}

机构：

[1] Univ Bordeaux, UMR 1219, INSERM, Bordeaux, France

[2] Univ Bordeaux, CIC1401 EC, INSERM, Bordeaux, France

[3] Hosp Univ, CHU Bordeaux, Pole Sante Publ Ctr, Bordeaux, France

[4] Hosp Univ, CHU Bordeaux, Pole Gerontol Clin, Bordeaux, France

[5] CATI Multictr Neuroimaging Platform, Paris, France

[6] Neurospin CEA Paris Saclay Univ, Gif Sur Yvette, France

[7] Sorbonne Univ, CNRS, INSERM, Lab Imagerie Biomed, Paris, France

[8] Hop La Pitie Salpetriere, AP HP, Med Nucl, Paris, France

[9] Sorbonne Univ, Grp Hosp, UMR S975,Pitie Salpetriere Inst Memoire & Maladie, AP HP,Inst Cerveau & Moelle Epiniere,INSERM,IM2A, Paris, France

[10] Sorbonne Univ, INSERM, U 1127, Inst Cerveau & Moelle Epiniere,CNRS 3,UMR 7225,CA, Paris, France

[11] Univ Toulouse III Paul Sabatier, INSERM, UMR1027, Toulouse, France

[12] Univ Lille, CHU, INSERM 1171, Ctr Memoire CMRR Distal, Lille, France

[13] Univ Paris 05, Hop Broca, Serv Geriatrie, Paris, France

[14] Univ Paris, Cognit Hop Lariboisiere, INSERM U1144, Ctr Neurol, Paris, France

[15] Univ Montpellier, Gui de Chauliac Hosp, Clin & Res Memory Ctr Montpellier, Dept Neurol,INSERM U1061, Montpellier, France

[16] CHU Timone, AP HM, Inst Neurosci Syst, CMMR,PACA Ouest,INSERM, Marseille, France

[17] Aix Marseille Univ, Marseille, France

[18] Univ Angers, Angers Univ Hosp, Angers Univ Memory Clin, Res Ctr Auton & Longev,UPRES EA4638,Dept Geriatr, Angers, France

[19] Univ Western Ontario, Dept Med Biophys, Robarts Res Inst, Schulich Sch Med & Dent, London, ON, Canada

[20] Univ Lyon, Hosp Civils Lyon, Hop Charpennes,Ctr Memoire Ressource & Rech Lyon, Ctr Rech Neurosci Lyon,INSERM U1028,CNRS,UMR5292, Lyon, France

[21] Univ Bourgogne, CHU Dijon Bourgogne, EA7460, Ctr Memoire Ressources & Rech, Dijon, France

[22] Hop St Louis, AP HP, Serv Neurol, Paris, France

[23] Univ Normandie, CHU Rouen, CNR MAJ, UNIROUEN,INSERM U1245,Dept Neurol, Caen, France

[24] CHU Grenoble, CMRR Grenoble Arc Alpin, Grenoble, France

[25] Univ Hosp Tours, CMRR, Tours, France

[26] Univ Bordeaux, CNRS, Ctr Resonance Magnet Syst Biol, UMR 5536, Bordeaux, France

[27] Clermont Auvergne Univ, CHU Clermont Ferrand, Memory Resource & Res Ctr Clermont Ferrand, Clermont Ferrand, France

来源：

NEUROLOGY | 2021年 / 97卷 / 08期

关键词：

BRAIN ATROPHY; ALZHEIMERS-DISEASE; INSULIN-RESISTANCE; RISK; MRI; AGE; HYPOMETABOLISM; ASSOCIATION; DEMENTIA; VOLUMES;

D O I：

10.1212/WNL.0000000000012440

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective To assess the role of biomarkers of Alzheimer disease (AD), neurodegeneration, and small vessel disease (SVD) as mediators in the association between diabetes mellitus and cognition. Methods The study sample was derived from MEMENTO, a cohort of French adults recruited in memory clinics and screened for either isolated subjective cognitive complaints or mild cognitive impairment. Diabetes was defined based on blood glucose assessment, use of antidiabetic agent, or self-report. We used structural equation modeling to assess whether latent variables of AD pathology (PET mean amyloid uptake, A beta(42)/A beta(40) ratio, and CSF phosphorylated tau), SVD (white matter hyperintensities volume and visual grading), and neurodegeneration (mean cortical thickness, brain parenchymal fraction, hippocampal volume, and mean fluorodeoxyglucose uptake) mediate the association between diabetes and a latent variable of cognition (5 neuropsychological tests), adjusting for potential confounders. Results There were 254 (11.1%) participants with diabetes among 2,288 participants (median age 71.6 years; 61.8% women). The association between diabetes and lower cognition was significantly mediated by higher neurodegeneration (standardized indirect effect: -0.061, 95% confidence interval: -0.089, -0.032), but not mediated by SVD and AD markers. Results were similar when considering latent variables of memory or executive functioning. Conclusion In a large clinical cohort in the elderly, diabetes is associated with lower cognition through neurodegeneration, independently of SVD and AD biomarkers.

引用

页码：E836 / E848

页数：13

共 46 条

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