Abstract:Structured Abstract
Aims
Anxiety, depression, accelerated cognitive decline, and increased risk of dementia are observed in individuals with type 2 diabetes. Anxiety and depression may contribute to lower performance on cognitive tests and differences in neuroimaging observed in individuals with type 2 diabetes.
Methods
These relationships were assessed in 655 European Americans with type 2 diabetes from 504 Diabetes Heart Study families. Participants completed cognitive testing, brain magnetic resonance im… Show more
“…The findings of several included studies suggest an association between T2DM and general cognitive deficits [ 30 , 38 , 45 , 47 , 51 ]. Reduced cognitive performance was noticed on different cognitive domains including working memory [ 8 , 30 , 32 , 38 , 45 , 46 , 47 , 48 , 51 ], attention [ 8 , 32 , 46 , 51 ], the speed of information processing [ 38 , 52 ], and executive function [ 8 , 32 , 51 ]. Surprisingly, some studies mainly demonstrated that the cognitive abnormalities may occur at early diabetic stages or may not be noticed even in old patients and after a long duration of illness [ 37 , 38 , 44 ].…”
Type 1 and type 2 diabetes mellitus have an impact on the microstructural environment and cognitive functions of the brain due to its microvascular/macrovascular complications. Conventional Magnetic Resonance Imaging (MRI) techniques can allow detection of brain volume reduction in people with diabetes. However, conventional MRI is insufficiently sensitive to quantify microstructural changes. Diffusion Tensor Imaging (DTI) has been used as a sensitive MRI-based technique for quantifying and assessing brain microstructural abnormalities in patients with diabetes. This systematic review aims to summarise the original research literature using DTI to quantify microstructural alterations in diabetes and the relation of such changes to cognitive status and metabolic profile. A total of thirty-eight published studies that demonstrate the impact of diabetes mellitus on brain microstructure using DTI are included, and these demonstrate that both type 1 diabetes mellitus and type 2 diabetes mellitus may affect cognitive abilities due to the alterations in brain microstructures.
“…The findings of several included studies suggest an association between T2DM and general cognitive deficits [ 30 , 38 , 45 , 47 , 51 ]. Reduced cognitive performance was noticed on different cognitive domains including working memory [ 8 , 30 , 32 , 38 , 45 , 46 , 47 , 48 , 51 ], attention [ 8 , 32 , 46 , 51 ], the speed of information processing [ 38 , 52 ], and executive function [ 8 , 32 , 51 ]. Surprisingly, some studies mainly demonstrated that the cognitive abnormalities may occur at early diabetic stages or may not be noticed even in old patients and after a long duration of illness [ 37 , 38 , 44 ].…”
Type 1 and type 2 diabetes mellitus have an impact on the microstructural environment and cognitive functions of the brain due to its microvascular/macrovascular complications. Conventional Magnetic Resonance Imaging (MRI) techniques can allow detection of brain volume reduction in people with diabetes. However, conventional MRI is insufficiently sensitive to quantify microstructural changes. Diffusion Tensor Imaging (DTI) has been used as a sensitive MRI-based technique for quantifying and assessing brain microstructural abnormalities in patients with diabetes. This systematic review aims to summarise the original research literature using DTI to quantify microstructural alterations in diabetes and the relation of such changes to cognitive status and metabolic profile. A total of thirty-eight published studies that demonstrate the impact of diabetes mellitus on brain microstructure using DTI are included, and these demonstrate that both type 1 diabetes mellitus and type 2 diabetes mellitus may affect cognitive abilities due to the alterations in brain microstructures.
“…In addition, besides the influence on patients' QOL, research shows that anxiety and depression will change the volume and mean diffusivity of the white and gray matter, which can ultimately result in cognitive disturbance. 38 These findings indicate that healthcare providers should assess psychological and physiological symptoms among patients with chronic diseases, especially for depression and anxiety, since those symptoms are easily neglected by patients and healthcare providers. Future research should not underestimate the impact of depression, anxiety, fatigue, and impaired sleep quality on patients with T2DM.…”
Section: Discussionmentioning
confidence: 99%
“…In addition, besides the influence on patients’ QOL, research shows that anxiety and depression will change the volume and mean diffusivity of the white and gray matter, which can ultimately result in cognitive disturbance. 38…”
The purpose of this study was to examine the collective effect of a symptom cluster (depression, anxiety, fatigue, and impaired sleep quality) at baseline on the quality of life (QOL) of patients with type 2 diabetes (T2DM) over time. Methods This was a secondary data analysis of 302 patients with T2DM who presented with both hypertension and hyperlipidemia. All of the participants were enrolled in a randomized controlled intervention study testing strategies to improve medication adherence. The psychological symptoms and QOL were assessed at baseline, 6 months, and 12 months. Cluster analysis was used to identify subgroups of patients based on the severity of symptoms at baseline. Results Hierarchical cluster analysis identified 4 patient subgroups: all low severity, mild, moderate, and all high severity. There were significant differences in patients' QOL overall among the 4 subgroups. Compared with the all-low-severity subgroup, subgroups with higher severity of the 4 symptoms had poorer QOL across all 3 time points. QOL was most impacted by trait anxiety across the 3 time points.
“…Information on risk factors could not be determined for two studies [ 36 , 47 ]. Anxiety and depression are possible modifying factors when assessing cognitive impairment, due to the potential effects these affective disorders have on confounding cognitive testing performance [ 65 ]. One study controlled for depressive symptoms, but cognitive performance was not an outcome of interest [ 37 ].…”
BackgroundTraditional and novel risk factors cannot sufficiently explain the differential susceptibility to cardiovascular disease (CVD). Epigenetics may serve to partially explain this residual disparity, with life course stressors shown to modify methylation of genes implicated in various diseases. Subclinical CVD is often comorbid with cognitive impairment (CI), which warrants research into the identification of common genes for both conditions.MethodsWe conducted a systematic review of the existing literature to identify studies depicting the relationship between life course stressors, DNA methylation, subclinical CVD, and cognition.ResultsA total of 16 articles (8 human and 8 animal) were identified, with the earliest published in 2008. Four genes (COMT, NOS3, Igfl1, and Sod2) were analyzed by more than one study, but not in association with both CVD and CI. One gene (NR3C1) was associated with both outcomes, albeit not within the same study. There was some consistency among studies with markers used for subclinical CVD and cognition, but considerable variability in stress exposure (especially in human studies), cell type/tissue of interest, method for detection of DNA methylation, and risk factors. Racial and ethnic differences were not considered, but analysis of sex in one human study found statistically significant differentially methylated X-linked loci associated with attention and intelligence.ConclusionsThis review suggests the need for additional studies to implement more comprehensive and methodologically rigorous study designs that can better identify epigenetic biomarkers to differentiate individuals vulnerable to both subclinical CVD and associated CI.Electronic supplementary materialThe online version of this article (10.1186/s12881-019-0764-4) contains supplementary material, which is available to authorized users.
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