Alzheimer Disease & Associated Disorders

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content="1" /><meta name="wkhealth_article_publication_date" content="July 10, 2019" /><meta name="wkhealth_volume" content="34" /><meta name="wkhealth_ovid_accession_number" content="00002093-202001000-00002" /><meta name="wkhealth_issn" content="0893-0341" /><meta name="wkhealth_title" content="Type 2 Diabetes Interacts With Alzheimer Disease Risk Factors to Predict Functional Decline" /><meta name="wkhealth_authors" content="Thomas, Kelsey R.;Bangen, Katherine J.;Weigand, Alexandra J.;Edmonds, Emily C.;Sundermann, Erin;Wong, Christina G.;Eppig, Joel;Werhane, Madeleine L.;Delano-Wood, Lisa;Bondi, Mark W." /><meta name="wkhealth_doi" content="10.1097/WAD.0000000000000332" /><meta name="wkhealth_abstract_html_url" content="https://journals.lww.com/alzheimerjournal/abstract/2020/01000/type_2_diabetes_interacts_with_alzheimer_disease.2.aspx" /><meta name="wkhealth_fulltext_html_url" content="https://journals.lww.com/alzheimerjournal/fulltext/2020/01000/type_2_diabetes_interacts_with_alzheimer_disease.2.aspx" /><meta name="wkhealth_toc_section" content="Original Articles" /><meta name="wkhealth_toc_sub_section" /><meta name="wkhealth_eJpId" content="alzheimerjournal:2020:01000:00002" /><meta name="wkhealth_firstpage" content="10" /><meta name="wkhealth_date" content="January-March 2020" /><meta name="wkhealth_pdf_url" content="https://journals.lww.com/alzheimerjournal/_layouts/15/oaks.journals/downloadpdf.aspx?trckng_src_pg=Other&an=00002093-202001000-00002" /><meta name="Description" content="Objective: The current study examined the interactive effect of type 2 diabetes and Alzheimer dis" /><meta property="og:site_name" content="LWW" /><meta property="og:type" content="article" /><meta property="og:title" content="Type 2 Diabetes Interacts With Alzheimer Disease Risk... : Alzheimer Disease & Associated Disorders" /><meta property="og:description" content="ents that included the Functional Activities Questionnaire, an informant-rated measure of everyday functioning. Multilevel modeling, controlling for demographic variables and ischemic risk, examined the interactive effects of diabetes status (diabetes, n=69; no diabetes, n=744) and AD risk factors in the prediction of 5-year longitudinal change in everyday functioning. One model was run for each AD risk factor, including: objectively-defined subtle cognitive decline (Obj-SCD), and genetic susceptibility [apolipoprotein E ε4 (APOE ε4) as well as cerebrospinal fluid β-amyloid (Aβ), total tau (tau), and hyperphosphorylated tau (p-tau). Results: The 3-way diabetes×AD risk factor×time interaction predicted increased rates of functional decline in models that examined Obj-SCD, APOE ε4, tau, and p-tau positivity, but not Aβ positivity. Conclusions: Participants with both diabetes and at least 1 AD risk factor (ie, Obj-SCD, APOE ε4, tau, and p-tau positivity) demonstrated faster functional decline compared with those without both risk factors (diabetes or AD). These findings have implications for early identification of, and perhaps earlier intervention for, diabetic individuals at risk for future functional difficulty...." /><meta property="og:image" content="https://images.journals.lww.com/alzheimerjournal/SocialThumb.00002093-202001000-00002.T1.jpeg" /><meta property="og:image:width" content="1318" /><meta property="og:image:height" content="660" /><meta property="og:url" content="https://journals.lww.com/alzheimerjournal/fulltext/2020/01000/type_2_diabetes_interacts_with_alzheimer_disease.2.aspx" /><meta property="twitter:card" content="summary" /><meta name="robots" content="index, follow, noarchive" /><meta name="WT.sv" content="ZUSE1PEJPWEB03" /><meta name="Title" content="Alzheimer Disease & Associated Disorders" /><style id="SPThemeHideForms" type="text/css">body {opacity:0 !important}</style>  <link href="https://fonts.googleapis.com/css?family=Arvo:400,400i,700|Fira+Sans:300,300i,400,400i,500,500i,600,600i,700,700i&display=swap" 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'Type 2 Diabetes Interacts With Alzheimer Disease Risk Factors to Predict Functional Decline', '07102019', 'Kelsey R. Thomas, Katherine J. Bangen, Alexandra J. Weigand, et al', '34', '1', 'Copyright \u00A9 2019 Wolters Kluwer Health, Inc. All rights reserved.', '00002093-202001000-00002', '', false, ''); } </script> <div id="ArticleContainer"> <article id="ej-abstract-view" xmlns:ssr="http://ssr-eus-go-csi.cloudapp.net/v1/assets" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xhtml="http://www.w3.org/1999/xhtml"><section class="ejp-r-article-subsection"><div class="ejp-r-article-subsection__text">Original Articles</div></section><header class="ejp-article-header"><h1 class="ejp-article-title">Type 2 Diabetes Interacts With Alzheimer Disease Risk Factors to Predict Functional Decline</h1></header><section id="ejp-article-authors"><p id="P7">Thomas, Kelsey R. PhD<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">*,†</sup>; Bangen, Katherine J. PhD<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">*,†</sup>; Weigand, Alexandra J. BA<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">*,†,‡</sup>; Edmonds, Emily C. PhD<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">*,†</sup>; Sundermann, Erin PhD<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">†</sup>; Wong, Christina G. PhD<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">*,†</sup>; Eppig, Joel MS<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">*,†,‡</sup>; Werhane, Madeleine L. MS<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">*,†,‡</sup>; Delano-Wood, Lisa PhD<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">*,†</sup>; Bondi, Mark W. PhD<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">*,†</sup></p><section><a href="#" id="ejp-article-authors-link"> Author Information <i class="wk-icon-arrow-down-r"></i></a></section></section><section id="ejp-article-authors-info" class="ejp-article-authors-info ejp-article-authors-info--hidden"><div class="ejp-article-authors-info-holder"> <p id=""><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">*</sup>Veterans Affairs San Diego Healthcare System</p> <p id=""><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">‡</sup>San Diego State University/University of California San Diego (SDSU/UCSD) Joint Doctoral Program in Clinical Psychology, San Diego</p> <p id=""><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">†</sup>Department of Psychiatry, University of California San Diego, La Jolla, CA</p> <p id="">Data used in the preparation of this article were obtained from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database (<span><a href="http://www.adni.loni.usc.edu" onclick="javascript:window.open('http://www.adni.loni.usc.edu');return false">www.adni.loni.usc.edu</a></span>). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. A complete listing of ADNI investigators can be found at: <span><a href="http://adni.loni.usc.edu/wp-content/uploads/how_to_apply/ADNI:Acknowledgement_List.pdf" onclick="javascript:window.open('http://adni.loni.usc.edu/wp-content/uploads/how_to_apply/ADNI:Acknowledgement_List.pdf');return false">http://adni.loni.usc.edu/wp-content/uploads/how_to_apply/ ADNI_Acknowledgement_List.pdf</a></span></p> <p id="">Supported by NIH grants R01 AG049810 (M.W.B.), K24 AG026431 (M.W.B.), the Alzheimer’s Association (AARF-17-528918 to K.R.T., AARG-17-500358 to E.C.E., and AARG-18-566254 to K.J.B.), and the U.S. Department of Veterans Affairs Clinical Sciences Research and Development Service (Career Development Award-2 1IK2CX001415 to E.C.E. and 1IK2CX000938 to K.J.B.). Data collection and sharing for this project was funded by the Alzheimer’s Disease Neuroimaging Initiative (ADNI) (National Institutes of Health Grant U01 AG024904) and DOD ADNI (Department of Defense award number W81XWH-12-2-0012). ADNI is funded by the National Institute on Aging, the National Institute of Biomedical Imaging and Bioengineering, and through generous contributions from the following: AbbVie, Alzheimer’s Association; Alzheimer’s Drug Discovery Foundation; Araclon Biotech; BioClinica Inc.; Biogen; Bristol-Myers Squibb Company; CereSpir Inc.; Cogstate; Eisai Inc.; Elan Pharmaceuticals Inc.; Eli Lilly and Company; EuroImmun; F. Hoffmann-La Roche Ltd and its affiliated company Genentech Inc.; Fujirebio; GE Healthcare; IXICO Ltd; Janssen Alzheimer Immunotherapy Research & Development, LLC; Johnson & Johnson Pharmaceutical Research & Development LLC.; Lumosity; Lundbeck; Merck & Co. Inc.; Meso Scale Diagnostics LLC; NeuroRx Research; Neurotrack Technologies; Novartis Pharmaceuticals Corporation; Pfizer Inc.; Piramal Imaging; Servier; Takeda Pharmaceutical Company; and Transition Therapeutics. The Canadian Institutes of Health Research is providing funds to support ADNI clinical sites in Canada. Private sector contributions are facilitated by the Foundation for the National Institutes of Health (<span><a href="http://www.fnih.org" onclick="javascript:window.open('http://www.fnih.org');return false">www.fnih.org</a></span>). The grantee organization is the Northern California Institute for Research and Education, and the study is coordinated by the Alzheimer’s Therapeutic Research Institute at the University of Southern California. ADNI data are disseminated by the Laboratory for Neuro Imaging at the University of Southern California.</p> <p id="">M.W.B. is a consulting editor for the <em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">Journal of the International Neuropsychological Society</em> and serves as a paid consultant for Novartis, Eisai, and Roche pharmaceutical companies. The remaining authors declare no conflicts of interest.</p> <p id="">Reprints: Mark W. Bondi, PhD, VA San Diego Healthcare System, 3350 La Jolla Village Drive (116B), San Diego, CA 92161 (e-mail: <span><a href="/cdn-cgi/l/email-protection#315c50585d455e0b5c535e5f555871445242551f545544" onclick="javascript:window.open('mailto:mailto:mbondi@ucsd.edu');return false"><span class="__cf_email__" data-cfemail="b1dcd3dedfd5d8f1c4d2c2d59fd4d5c4">[email protected]</span></a></span>).</p> </div></section><section id="article-journal-info"><div class="ej-journal-info"><span class="ej-journal-name">Alzheimer Disease & Associated Disorders </span><span id="ej-journal-date-volume-issue-pg"><a href="/alzheimerjournal/toc/2020/01000">34(1):p 10-17, January–March 2020.</a></span><span> | </span><span class="ej-journal-doi">DOI: </span>10.1097/WAD.0000000000000332</div></section><section id="ejp-article-indicators" class="ejp-article-indicators"><ul class="ejp-article-indicators__list"> <li id="ej-article-indicators-buy" class="ejp-article-indicators__list-item" onmouseover="javascript:Tooltip_Buy()" onmouseout="javascript:Tooltip_MouseOut()"><a href="#ContentAccessOptions"><span class="ejp-indicator">Buy</span></a></li> <li id="ej-article-indicators-sam" class="ejp-article-indicators__list-item" onmouseover="javascript:Tooltip_SDC()" onmouseout="javascript:Tooltip_MouseOut()"><span class="ejp-indicator">SDC</span></li> </ul><button id="openArticleMetricsPopupButton" type="button" class="wk-button wk-button-ghost wk-button-icon-left ejp-article-metrics-btn" data-articleMetricsEndpoint="//services.journals.lww.com/IntegrationServices/ArticleMetricsService.svc" data-articleMetricsDetailsUrl="https://wolterskluwer.altmetric.com/details/" data-doi="10.1097/WAD.0000000000000332" data-suiteId="vrs_woltere_journalsglobalvrs" data-articlePublicationDate="2019-07-10" data-articlePublicationDateString="July 10, 2019" data-receivedDate="2019-01-23" data-revisionReceivedDate="" data-acceptedDate="2019-05-28" data-crossrefRefLinkRoot="https://doi.org/" data-medlineRefLinkRoot="http://www.ncbi.nlm.nih.gov/pubmed/" data-pubMedId=""><i class="wk-icon-filled-chart-r"></i><i class="wk-icon-filled-chart-white-r"></i> Metrics </button></section><section class="ejp-article-tabs" id="abstractWrap"><h2 class="ejp-article-tabs-heading">Abstract</h2> <div class="ejp-article-tabs__tabpanel" id="panel1" role="tabpanel" aria-labelledby="tab1"> <div id="article-abstract-content1"> <div class="ejp-article-text-abstract"> <h3>Objective: </h3> <p>The current study examined the interactive effect of type 2 diabetes and Alzheimer disease (AD) risk factors on the rate of functional decline in cognitively normal participants from the Alzheimer’s Disease Neuroimaging Initiative.</p> <h3>Methods: </h3> <p>Participants underwent annual assessments that included the Functional Activities Questionnaire, an informant-rated measure of everyday functioning. Multilevel modeling, controlling for demographic variables and ischemic risk, examined the interactive effects of diabetes status (diabetes, n=69; no diabetes, n=744) and AD risk factors in the prediction of 5-year longitudinal change in everyday functioning. One model was run for each AD risk factor, including: objectively-defined subtle cognitive decline (Obj-SCD), and genetic susceptibility [apolipoprotein E ε4 (APOE ε4) as well as cerebrospinal fluid β-amyloid (Aβ), total tau (tau), and hyperphosphorylated tau (p-tau).</p> <h3>Results: </h3> <p>The 3-way diabetes×AD risk factor×time interaction predicted increased rates of functional decline in models that examined Obj-SCD, APOE ε4, tau, and p-tau positivity, but not Aβ positivity.</p> <h3>Conclusions: </h3> <p>Participants with both diabetes and at least 1 AD risk factor (ie, Obj-SCD, APOE ε4, tau, and p-tau positivity) demonstrated faster functional decline compared with those without both risk factors (diabetes or AD). These findings have implications for early identification of, and perhaps earlier intervention for, diabetic individuals at risk for future functional difficulty.</p> </div> </div> </div></section><section class="ej-article-copyright">Copyright © 2019 Wolters Kluwer Health, Inc. 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