Associations between anxiety and depression symptoms and cognitive testing and neuroimaging in type 2 diabetes
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Brenes, Gretchen A.
Cox, Amanda J.
Freedman, Barry I.
Hugenschmidt, Christina E.
Hsu, Fang-Chi
Xu, Jianzhao
Wagner, Benjamin C.
Williamson, Jeff D.
Maldjian, Joseph A.
Bowden, Donald W.
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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 imaging, the Brief Symptom Inventory Anxiety subscale, and the Center for Epidemiologic Studies Depression-10. Results: In analyses adjusted for age, sex, educational attainment, and use of psychotropic medications, individuals with comorbid anxiety and depression symptoms had lower performance on all cognitive testing measures assessed (p ≤ 0.005). Those with both anxiety and depression also had increased white matter lesion volume (p = 0.015), decreased gray matter cerebral blood flow (p = 4.43 × 10− 6), decreased gray matter volume (p = 0.002), increased white and gray matter mean diffusivity (p ≤ 0.001), and decreased white matter fractional anisotropy (p = 7.79 × 10− 4). These associations were somewhat attenuated upon further adjustment for health status related covariates. Conclusions: Comorbid anxiety and depression symptoms were associated with cognitive performance and brain structure in a European American cohort with type 2 diabetes.
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Journal of Diabetes and its Complications
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30
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1
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Clinical Sciences not elsewhere classified
Clinical Sciences