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O1‐14‐03: NATURAL HISTORY OF SUBCORTICAL VASCULAR COGNITIVE IMPAIRMENT: AN 8.5‐YEAR LONGITUDINAL STUDY
Author(s) -
Kim Hee Jin,
Woo Sook young,
Kim Seonwoo,
Jang Hyemin,
Cho Su Hyun,
Kim Seung Joo,
Lee Kyung Han,
Kim sung Tae,
Kim Jae Seung,
Lee Jae-Hong,
Na Duk L.,
Seo Sang Won
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.2018.06.3049
Subject(s) - clinical dementia rating , hyperintensity , cognitive impairment , dementia , vascular dementia , neuropsychology , cognitive decline , cognition , medicine , longitudinal study , natural history , psychology , psychiatry , magnetic resonance imaging , disease , pathology , radiology
disease and poorer cognition), 2-1, and 2-2 (associated with greater risk for myocardial infarction and mortality). An additional polymorphism in the promoter of the Hp2 allele, restricted to AA descent, yields a fourth genotype, Hp 2-1m. AA have higher prevalence of Hp 1-1 (w33%) compared to Whites (w14%), but the role of the Hp genotype in cognition in AA individuals is unknown. Methods:We used publicly available data and specimens from The Action to Control Cardiovascular Risk in Diabetes-Memory in Diabetes (ACCORD-MIND) study to investigate the association of Hp genotypes with cognitive performance and decline in 466 AA T2D participants. We hypothesized that the Hp 1-1 genotype is associated with greater cognitive impairment and faster cognitive decline compared to other genotypes. Associations were examined with ANCOVA and linear regression adjusting for sociodemographic and T2D-related characteristics. Results:Genotype prevalence was Hp 1-1:29.4%, Hp 2-1:36.1%, Hp 2-1m:10.9%, and Hp 2-2:23.6%. In the overall ANCOVA, the groups differed in their MMSE (p1⁄40.006; Figure). At baseline Hp 2-1m had the highest MMSE score (mean1⁄427.2; SE1⁄40.36, and Hp 1-1 had the poorest MMSE score (mean1⁄425.7; SE1⁄40.23). The MMSE declined in the Hp1-1(adjusted mean decline -0.42 over 40 months), 2-1 (-0.21) and 2-2 (-0.65) genotype carriers whereas the Hp2-1m carriers improved (0.14). The change model adjusted for the same set of covariates, in addition to baseline MMSE. The 40-month decline was significant for Hp 2-2 (p1⁄40.004) and Hp 1-1 (p1⁄40.045). However, the overall comparison across the four groups did not reach statistical significance (p1⁄40.202). Conclusions: The Hp 1-1 genotype, which is 2-fold more prevalent in AA than in Whites, is associated with poorer cognitive function in T2D AA participants in the ACCORD MIND study. Future studies of Hp genotype using more sensitive tests of cognitive function are warranted.