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Understanding the interrelationships of type-2 diabetes and hypertension with brain and cognitive health: a UK Biobank study

Newby, Danielle; Garfield, Victoria; (2022) Understanding the interrelationships of type-2 diabetes and hypertension with brain and cognitive health: a UK Biobank study. Diabetes, Obesity and Metabolism: a journal of pharmacology and therapeutics 10.1111/dom.14658. (In press). Green open access

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Abstract

AIMS: To understand the impact of diabetes and comorbid hypertension on cognitive and brain health. MATERIALS AND METHODS: We used data from the UK Biobank cohort consisting of ~500,000 individuals aged 40-69 years. Our outcomes included brain structural MRI parameters and cognitive function tests in a maximum of 38918 individuals. We firstly tested associations with all outcomes between those with diabetes (n = 2043) and without (n = 36875) and secondly compared those with comorbid diabetes/hypertension (n=1283) with those with only diabetes (n=760), hypertension (n=9649) and neither disease (n=27226). Our analytical approach comprised linear regression models, with adjustment for a range of demographic and health factors. Standardised betas were reported. RESULTS: Those with diabetes had worse brain and cognitive health for the majority of neuroimaging and cognitive measures with the exception of gFA (white matter integrity), amygdala, pairs matching and tower rearranging. Compared to individuals with comorbid diabetes and hypertension, those with only hypertension had better brain health overall, with the largest difference observed in the pallidum (β=0.189, 95%CI=0.241;0.137), while those with only diabetes differed in total grey volume (β=0.150, 95%CI=0.122;0.179). Individuals with only diabetes had better verbal and numeric reasoning (β=0.129, 95%CI=0.077;0.261), whereas those with only hypertension performed better on the symbol digit substitution task (β=0.117, 95%CI=0.048;0.186). CONCLUSIONS: Individuals with comorbid diabetes and hypertension have worse brain and cognitive health compared to those with only one of these diseases. These findings potentially suggest that prevention of both diabetes and hypertension may delay changes in brain structure, as well as cognitive decline and dementia diagnosis. This article is protected by copyright. All rights reserved.

Type: Article
Title: Understanding the interrelationships of type-2 diabetes and hypertension with brain and cognitive health: a UK Biobank study
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/dom.14658
Publisher version: https://doi.org/10.1111/dom.14658
Language: English
Additional information: Copyright © 2022 The Authors. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Keywords: brain health, cardiovascular disease, dementia, diabetes, epidemiology, hypertension
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine > MRC Unit for Lifelong Hlth and Ageing
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10143815
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