Diabetes mellitus and cognition - Sorbonne Université
Journal Articles Neurology Year : 2021

Diabetes mellitus and cognition

1 BPH - Bordeaux population health
2 CATI - Centre d'Acquisition et de Traitement des Images [Paris] = CATI Multicenter Neuroimaging Platform
3 IFR49 - Neurospin - CEA
4 CHU Pitié-Salpêtrière [AP-HP]
5 LIB - Laboratoire d'Imagerie Biomédicale [Paris]
6 ICM - Institut du Cerveau = Paris Brain Institute
7 UT3 - Université Toulouse III - Paul Sabatier
8 CMRR - Centre Mémoire de Ressources et de Recherche [Lille-Bailleul]
9 Groupe hospitalier Broca
10 OPTeN (UMR_S 1144 / U1144) - Optimisation thérapeutique en Neuropsychopharmacologie
11 Hôpital Lariboisière-Fernand-Widal [APHP]
12 Hôpital Gui de Chauliac [CHU Montpellier]
13 INM - Institut des Neurosciences de Montpellier
14 INS - Institut de Neurosciences des Systèmes
15 LPPL - Laboratoire de Psychologie des Pays de la Loire
16 UWO - University of Western Ontario
17 CRNL - Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center
18 PEC2 - Physiopathologie et épidémiologie cérébro-cardiovasculaire [Dijon]
19 AP-HP - Hopital Saint-Louis [AP-HP]
20 GPMCND - Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques
21 CMRR - Centre Mémoire de Ressources et de Recherche [Grenoble]
22 CHU Trousseau [Tours]
23 CRMSB - Centre de résonance magnétique des systèmes biologiques
24 UCA - Université Clermont Auvergne
25 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
26 Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB)
Eric Frison
Cecile Proust-Lima
Catherine Belin
Carole Dufouil
  • Function : Correspondent author
  • PersonId : 1104356

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Abstract

Objective: To assess the role of biomarkers of Alzheimer's 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 modelling to assess whether latent variables of AD pathology (PET mean amyloid uptake, Aβ42/Aβ40 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 (five 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.
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hal-03278377 , version 1 (05-07-2021)

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Eric Frison, Cecile Proust-Lima, Jean-Francois Mangin, Marie-Odile Habert, Stephanie Bombois, et al.. Diabetes mellitus and cognition. Neurology, 2021, 97 (8), pp.e836-e848. ⟨10.1212/WNL.0000000000012440⟩. ⟨hal-03278377⟩
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