Premium
P3‐496: SEVERE HYPOGLYCEMIA AND COGNITIVE FUNCTIONING IN OLDER ADULTS WITH TYPE 1 DIABETES: THE STUDY OF LONGEVITY IN DIABETES (SOLID)
Author(s) -
Lacy Mary E.,
Gilsanz Paola,
Beeri Michal Schnaider,
Karter Andrew J.,
Quesenberry Charles P.,
Whitmer Rachel A.
Publication year - 2018
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2018.06.1860
Subject(s) - memory span , verbal fluency test , type 1 diabetes , cognition , stroop effect , working memory , medicine , hypoglycemia , cognitive test , cognitive decline , glycemic , audiology , diabetes mellitus , psychology , type 2 diabetes , association (psychology) , trail making test , dementia , psychiatry , neuropsychology , disease , endocrinology , psychotherapist
matter hyperintensities (WMH) were quantified from T2-FLAIR images using SPM8. A subset (n1⁄463) completed lumbar puncture for CSF acquisition, including Ab42, ptau, total tau, and neurofilament light (NFL, pg/mL). Linear regressions separately related brain volumes and CSF concentrations to PVLT indices adjusting for age, sex, education, race/ethnicity, Framingham Stroke Risk Profile, APOE-e4 status, and ICV (for imaging models). For PVLT outcomes with multiple biomarker predictors, competitive models were generated using hierarchical regression to examine the independent contribution of each predictor. Results:CSF Ab42, ptau, and total tau were unrelated to all PVLT indices (p-values>0.20). Greater WMH (notably in frontal and parietal lobes) related to worse PVLT performances (p-values<0.05). Higher CSF NFL related to lower Total Learning scores (p1⁄40.04). Smaller left hippocampal volume (L-HPCV) related to worse Long Delay Free Recall (LDFR; p1⁄40.02) and Discrimination (p1⁄40.03). In competitive models, NFL related to Total Learning (p1⁄40.01) while the WMH association was attenuated (p1⁄40.12). NFL explained 8% of unique variance in Total Learning. Similarly, in competitive models, WMH and L-HPCV remained significant predictors of LDFR and Discrimination (p-values<0.03), each explaining 24% of unique variance. Conclusions: When comparing multiple brain health biomarkers, white matter integrity appears critical to verbal episodic memory in cognitively normal older adults, often beyond medial temporal lobe structures and CSF markers of Alzheimer’s disease and neurodegeneration. This observed pattern may reflect underlying brain changes associated with normal aging processes or other non-Alzheimer’s disease pathways. Funding: K23-AG045966, K01-AG049164, IIRG-08-88733, R01AG034962, R01-AG056534, R01-NS100980, K24-AG046373.