The relationship between the score on a simple measure of cognitive function & incident CVD in people with diabetes: a post-hoc epidemiological analysis from the ACCORD-MIND study.

The relationship between the score on a simple measure of cognitive function & incident CVD in people with diabetes: a post-hoc epidemiological analysis from the ACCORD-MIND study.

J Clin Endocrinol Metab. 2017 Jun 01;:

Authors: Cukierman-Yaffe T, Gerstein HC, Miller ME, Launer LJ, Williamson J, Horowitz KR, Ismail-Beigi F, Lazar RM

Abstract
Context and Objective: Diabetes is associated with a greater risk for incident cardio-vascular disease and for cognitive dysfunction. This study aimed to investigate, in people with Type 2 diabetes the association of a simple measure of cognitive function to CVD events and mortality.
Design, Setting, Participants, Measurements & Outcomes: The ACCORD trial included persons with long-standing T2D. A sub-study of 2977 (MIND) participants age => 55 years aimed to test the effect of the interventions on brain structure and function. At baseline participants were administered a cognitive battery that included the Digit Symbol Substitution Test (DSST). The associations of the DSST and the ACCORD primary outcome (the first occurrence of nonfatal myocardial infarction, or nonfatal stroke or death from cardiovascular causes) and all-cause mortality, were investigated with Cox proportional hazard models adjusting for several demographic and clinical variables.
Results: Median follow-up time was 4.27 years. An inverse relationship between the incidence of the ACCORD primary outcome and baseline cognitive score was demonstrated. A 1 point higher DSST score was associated with a lower incidence of the primary outcome (HR=0.987, 95% CI 0.977- 0.998; p=0.019), after adjustment for demographic and clinical trial factors, additional baseline cardiovascular risk factors and self-reported need for assistance to follow the protocol .
Conclusion: Lower scores on the DSST, a simple, sensitive neuropsychological instrument are associated with a higher incidence of cardiovascular events in persons>55 years old with long-standing diabetes.

PMID: 28575229 [PubMed - as supplied by publisher]

http://ift.tt/2rvn39h