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Ankle‐brachial index and inter‐artery blood pressure differences as predictors of cognitive function in overweight and obese older adults with diabetes: results from the Action for Health in Diabetes movement and memory study
Author(s) -
Espeland Mark A.,
Beavers Kristen M.,
Gibbs Bethany Barone,
Johnson Karen C.,
Hughes Timothy M.,
Baker Laura D.,
Jakicic John,
Korytkowski Mary,
Miller Marsha,
Bray George A.
Publication year - 2015
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.4253
Subject(s) - overweight , medicine , diabetes mellitus , ankle , blood pressure , brachial artery , obesity , gerontology , physical therapy , body mass index , physical medicine and rehabilitation , surgery , endocrinology
Objective Ankle‐brachial index (ABI) and interartery systolic blood pressure differences, as markers of vascular disease, are plausible risk factors for deficits in cognitive function among overweight and obese adults with type 2 diabetes. Methods The ABI and maximum interartery differences (MIAD) in systolic blood pressures were assessed annually for five years among 479 participants assigned to the control condition in a randomized clinical trial of a behavioral weight loss intervention. A battery of standardized cognitive function tests was administered 4 to 5 years later. Analyses of covariance were used to assess relationships that ABI, MIAD, and progression of ABI and MIAD had with cognitive function. Results There was a curvilinear relationship between ABI and a composite index of cognitive function ( p = 0.03), with lower ABI being associated with poorer function. In graded fashions, both greater MIAD and increases in MIAD over time also had modest relationships with poorer verbal memory (both p ≤ 0.05), processing speed (both p ≤ 0.05), and composite cognitive function (both p < 0.04). These relationships were independent of each other and remained evident after extensive covariate adjustment. Conclusions In overweight and obese adults with type 2 diabetes, lower ABI and larger interartery systolic blood pressure differences have modest, independent, graded relationships with poorer cognitive function 4–5 years later. Copyright © 2014 John Wiley & Sons, Ltd.