Type 2 Diabetes Interacts With Alzheimer Disease Risk Factors to Predict Functional Decline

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These findings have implications for early identification of, and perhaps earlier int …"><meta name="keywords" content="pmid:31305320, PMC6952586, doi:10.1097/WAD.0000000000000332, Kelsey R Thomas, Katherine J Bangen, CollabAuthor(name='Alzheimer’s Disease Neuroimaging Initiative', investigators=[], affs=[]), Activities of Daily Living*, Aged, Amyloid beta-Peptides / cerebrospinal fluid, Apolipoprotein E4 / genetics, Cognitive Dysfunction*, Diabetes Mellitus, Type 2 / complications*, Female, Genotype, Healthy Volunteers*, Humans, Male, Middle Aged, Risk Factors, tau Proteins / cerebrospinal fluid, PubMed Abstract, NIH, NLM, NCBI, National Institutes of Health, National Center for Biotechnology Information, National Library of Medicine, MEDLINE"><meta name="robots" content="index,nofollow,noarchive"><meta property="og:title" content="Type 2 Diabetes Interacts With Alzheimer Disease Risk Factors to Predict Functional Decline - PubMed"><meta property="og:url" content="https://pubmed.ncbi.nlm.nih.gov/31305320/"><meta property="og:description" content="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). 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new collection</label> </li> <li> <input type="radio" id="collections-action-panel-existing" class="collections-existing" name="collections" value="existing" checked="true" data-ga-category="save_share" data-ga-action="collections" data-ga-label="collections_radio_existing"> <label for="collections-action-panel-existing">Add to an existing collection</label> </li> </ul> </div> <div class="controls-wrapper"> <div class="action-panel-control-wrap new-collections-controls"> <label for="collections-action-panel-add-to-new" class="action-panel-label required-field-asterisk"> Name your collection: </label> <input type="text" name="add-to-new-collection" id="collections-action-panel-add-to-new" class="collections-action-add-to-new" pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/" maxlength="100" data-ga-category="save_share" data-ga-action="create_collection" data-ga-label="non_favorties_collection"> <div class="collections-new-name-too-long usa-input-error-message selection-validation-message"> Name must be less than 100 characters </div> </div> <div class="action-panel-control-wrap existing-collections-controls"> <label for="collections-action-panel-add-to-existing" class="action-panel-label"> Choose a collection: </label> <select id="collections-action-panel-add-to-existing" class="action-panel-selector collections-action-add-to-existing" data-ga-category="save_share" data-ga-action="select_collection" data-ga-label="($('#collections-action-add-to-existing').val() === 'Favorites') ? 'Favorites' : 'non_favorites_collection'"> </select> <div class="collections-retry-load-on-error usa-input-error-message selection-validation-message"> Unable to load your collection due to an error<br> <a href="#">Please try again</a> </div> </div> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Adding..." data-pinger-ignore data-ga-category="save_share" data-ga-action="collections" data-ga-label="add"> Add </button> <button class="action-panel-cancel" aria-label="Close 'Add to Collections' panel" ref="linksrc=close_collections_panel" aria-controls="collections-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="collections" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="bibliography-action-panel" class="bibliography-action-panel action-panel in-progress-dots-panel" aria-hidden="true" data-bibliography-open-panel-enabled="false" data-bibliography-open-panel-url-hash="#open-bibliography-panel"> <div class="inner-wrap"> <h3 class="action-panel-heading"> Add to My Bibliography </h3> <form id="bibliography-action-panel-form" class="bibliography-action-panel-form action-panel-content action-form action-panel-smaller-selectors" data-add-to-bibliography-max-amount="100" data-add-to-bibliography-batch-size="10" data-bibliography-delegates-url="/list-bibliography-delegates/" data-add-to-bibliography-url="/add-to-bibliography/" data-get-article-ids-by-search-url="/get-article-ids-by-search/" data-mybib-root-url="https://www.ncbi.nlm.nih.gov/myncbi/collections/mybibliography/"> <input type="hidden" name="csrfmiddlewaretoken" value="D0Ftl0DIoGezGgQ9NlAxpX8h0TSQlu7qIopukOvlzJ4FNZgUcYMnowL3ug1wM9jb"> <div class="action-panel-control-wrap bibliographies-controls"> <div class="choice-group"> <ul class="bibliographies-action-add radio-group-items"> <li> <input name="bibliography" id="my-bibliography" class="my-bibliography" type="radio" checked/> <label for="my-bibliography">My Bibliography</label> </li> </ul> </div> </div> <div class="bibliographies-retry-load-on-error usa-input-error-message selection-validation-message"> Unable to load your delegates due to an error<br> <a href="#">Please try again</a> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Adding..." data-pinger-ignore> Add </button> <button class="action-panel-cancel" aria-label="Close 'Add to bibliography' panel" ref="linksrc=close_bibliography_panel" aria-controls="bibliography-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="mybib" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="saved-search-action-panel" class="saved-search-action-panel action-panel " aria-hidden="true" data-saved-search-open-panel-enabled="false" data-saved-search-open-panel-url-hash="#open-saved-search-panel"> <div class="inner-wrap"> <h2 class="action-panel-heading"> Your saved search </h2> <form id="saved-search-action-panel-form" class="saved-search-action-panel-form action-panel-content action-form" data-create-saved-search-url="/create-saved-search/" data-try-search-terms-url="/try-search-term/" data-saved-search-root-url="https://www.ncbi.nlm.nih.gov/myncbi/searches/"> <input type="hidden" name="csrfmiddlewaretoken" value="D0Ftl0DIoGezGgQ9NlAxpX8h0TSQlu7qIopukOvlzJ4FNZgUcYMnowL3ug1wM9jb"> <div class="action-panel-control-wrap"> <label for="saved-search-name" class="action-panel-label saved-search-name-label required-field-asterisk"> Name of saved search: </label> <input maxlength="200" type="text" name="saved-search-name" id="saved-search-name" class="saved-search-name" value="" required pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/"> </div> <div class="action-panel-control-wrap"> <label for="saved-search-term" class="action-panel-label required-field-asterisk"> Search terms: </label> <textarea name="saved-search-term" id="saved-search-term" class="saved-search-term" required></textarea> </div> <div class="test-search-term-wrap"> <a href="#" class="try-search-term">Test search terms</a> </div> <div class="choice-group action-panel-extra-margin-top"> <span class="action-panel-label" id="fieldset-label"> Would you like email updates of new search results? </span> <fieldset id="saved-search-alert" aria-describedby="fieldset-label"> <legend class="usa-sr-only">Saved Search Alert Radio Buttons</legend> <ul class="radio-group-items"> <li> <input type="radio" id="saved-search-alert-yes" class="saved-search-alert-yes" name="saved-search-alert" value="yes" checked> <label for="saved-search-alert-yes" class="action-panel-label">Yes</label> </li> <li> <input aria-label="No radio input" type="radio" id="saved-search-alert-no" class="saved-search-alert-no" name="saved-search-alert" value="no"> <label for="saved-search-alert-no" class="action-panel-label">No</label> </li> </ul> </fieldset> </div> <div class="alert-schedule-wrap"> <div class="action-panel-control-wrap"> <label class="action-panel-label"> Email: </label> <span aria-label="Email address" id="saved-search-email" class="action-panel-label"><span class="action-panel-label-bold"></span> (<a class="myncbi-account-settings" href="https://www.ncbi.nlm.nih.gov/account/settings/">change</a>)</span> </div> <div class="action-panel-control-wrap action-panel-extra-margin-top"> <label for="saved-search-frequency" class="action-panel-label"> Frequency: </label> <select id="saved-search-frequency" class="no-border-panel-selector saved-search-frequency"> <option value="monthly">Monthly</option> <option value="weekly">Weekly</option> <option value="daily">Daily</option> </select> </div> <div class="action-panel-control-wrap saved-search-monthly-additional"> <label for="saved-search-monthly-on-day" class="action-panel-label"> Which day? </label> <select id="saved-search-monthly-on-day" class="no-border-panel-selector"> <option value="Sunday">The first Sunday</option> <option value="Monday">The first Monday</option> <option value="Tuesday">The first Tuesday</option> <option value="Wednesday">The first Wednesday</option> <option value="Thursday">The first Thursday</option> <option value="Friday">The first Friday</option> <option value="Saturday">The first Saturday</option> <option value="day">The first day</option> <option value="weekday">The first weekday</option> </select> </div> <div class="action-panel-control-wrap saved-search-weekly-additional"> <label for="saved-search-weekly-on-day" class="action-panel-label"> Which day? </label> <select id="saved-search-weekly-on-day" class="no-border-panel-selector saved-search-weekly-on-day"> <option value="Sunday">Sunday</option> <option value="Monday">Monday</option> <option value="Tuesday">Tuesday</option> <option value="Wednesday">Wednesday</option> <option value="Thursday">Thursday</option> <option value="Friday">Friday</option> <option value="Saturday">Saturday</option> </select> </div> <div class="action-panel-control-wrap"> <label for="saved-search-report" class="action-panel-label"> Report format: </label> <select id="saved-search-report" class="no-border-panel-selector saved-search-report"> <option value="DocSum">Summary</option> <option value="DocSumText">Summary (text)</option> <option value="Abstract">Abstract</option> <option value="AbstractText">Abstract (text)</option> <option value="MEDLINE">PubMed</option> </select> </div> <div class="action-panel-control-wrap"> <label for="saved-search-amount" class="action-panel-label"> Send at most: </label> <select id="saved-search-amount" class="no-border-panel-selector saved-search-amount"> <option value="1">1 item</option> <option value="5" selected>5 items</option> <option value="10">10 items</option> <option value="20">20 items</option> <option value="50">50 items</option> <option value="100">100 items</option> <option value="200">200 items</option> </select> </div> <div> <input type="checkbox" id="saved-search-send-if-no-result" class="saved-search-send-if-no-result" name="saved-search-send-if-no-result"> <label for="saved-search-send-if-no-result" class="action-panel-label smaller-checkbox"> Send even when there aren't any new results </label> </div> <div class="action-panel-control-wrap option-text-in-email-wrap"> <label for="saved-search-email-text" class="action-panel-label"> Optional text in email: </label> <textarea name="saved-search-email-text" id="saved-search-email-text" class="saved-search-email-text"></textarea> </div> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Saving..." data-ga-category="save_share" data-ga-action="alert" data-ga-label="save"> Save </button> <button class="action-panel-cancel" aria-label="Close 'Your saved search' panel" ref="linksrc=close_saved_search_panel" aria-controls="saved-search-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="alert" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="citation-manager-action-panel" class="citation-manager-action-panel action-panel" aria-hidden="true"> <div class="inner-wrap"> <h2 class="action-panel-heading"> Create a file for external citation management software </h2> <form id="citation-manager-action-panel-form" class="action-panel-content action-form" action="/results-export-ids/" data-by-search-action="/results-export-search-data/" data-by-ids-action="/results-export-ids/" method="post" data-by-search-method="post" data-by-ids-method="post"> <input type="hidden" name="csrfmiddlewaretoken" value="D0Ftl0DIoGezGgQ9NlAxpX8h0TSQlu7qIopukOvlzJ4FNZgUcYMnowL3ug1wM9jb"> <input name="results-format" type="hidden" value="pubmed"/> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Sending..." data-ga-category="save_share" data-ga-action="citation_manager" data-ga-label="save"> Create file </button> <button class="action-panel-cancel" aria-label="Close 'Send citations to citation manager' panel" ref="linksrc=close_citation_manager_panel" aria-controls="citation-manager-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="citation_manager" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="rss-action-panel" class="rss-action-panel action-panel " aria-hidden="true"> <div class="inner-wrap"> <h2 class="action-panel-heading"> Your RSS Feed </h2> <form id="rss-action-panel-form" class="rss-action-panel-form action-panel-content action-form" data-create-rss-feed-url="/create-rss-feed-url/" data-search-form-term-value=""> <input type="hidden" name="csrfmiddlewaretoken" value="D0Ftl0DIoGezGgQ9NlAxpX8h0TSQlu7qIopukOvlzJ4FNZgUcYMnowL3ug1wM9jb"> <div class="action-panel-control-wrap"> <label for="rss-name" class="action-panel-label required-field-asterisk"> Name of RSS Feed: </label> <input maxlength="200" placeholder="Name" type="text" name="rss-name" id="rss-name" class="rss-name" value='' required pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/"> </div> <div class="rss-limit-wrap"> <div class="action-panel-control-wrap action-panel-extra-margin-top"> <label for="rss-limit" class="action-panel-label"> Number of items displayed: </label> <select id="rss-limit" class="no-border-panel-selector rss-limit"> <option value="5">5</option> <option value="10">10</option> <option value="15" selected="selected">15</option> <option value="20">20</option> <option value="50">50</option> <option value="100">100</option> </select> </div> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Creating..." data-ga-category="save_share" data-ga-action="alert" data-ga-label="save"> Create RSS </button> <button class="action-panel-cancel" aria-label="Close 'Your RSS' panel" ref="linksrc=close_rss_panel" aria-controls="rss-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="alert" data-ga-label="cancel"> Cancel </button> </div> <div class="action-panel-control-wrap rss-link-copy-wrap"> <label for="rss-link" class="usa-sr-only">RSS Link</label> <input placeholder="Your RSS Feed Link" type="text" name="rss-link" id="rss-link" class="rss-link" title="RSS Link"> <button type="button" disabled class="rss-link-copy-button disabled" data-ga-category="save_share" data-ga-action="rss" data-ga-label="copy"> Copy </button> </div> </form> </div> </div> </div> </div> <div class="article-page" id="article-page" data-article-pmid="31305320"> <aside class="page-sidebar"> <div class="inner-wrap"> <div class="full-text-links"> <div class="full-view"> <h3 class="title"> Full text links </h3> <div class="full-text-links-list"> <a class="link-item dialog-focus" href="https://doi.org/10.1097/WAD.0000000000000332" target="_blank" rel="noopener" ref="linksrc=fulltextorjournal_fulltext&is_pmc=False&PrId=3159&itool=Abstract-def&log$=linkouticon&uid=31305320&db=pubmed&nlmid=8704771" title="See full text options at Wolters Kluwer" data-ga-category="full_text" data-ga-action="Wolters Kluwer" data-ga-label="31305320" ><img src="https://cdn.ncbi.nlm.nih.gov/corehtml/query/egifs/https:--tools.ovid.com-images-wklogo.jpg" alt="full text provider logo"><span class="text"> Wolters Kluwer </span></a><a class="link-item pmc " href="https://pmc.ncbi.nlm.nih.gov/articles/pmid/31305320/" target="_blank" rel="noopener" ref="linksrc=fulltextorjournal_fulltext&is_pmc=True&PrId=3494&itool=Abstract-def&log$=linkouticon&uid=31305320&db=pubmed&nlmid=8704771" title="Free full text at PubMed Central" data-ga-category="full_text" data-ga-action="PMC" data-ga-label="31305320" ><span class="text"> Free PMC article </span></a> </div> </div> <div class="short-view"> <a 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value="D0Ftl0DIoGezGgQ9NlAxpX8h0TSQlu7qIopukOvlzJ4FNZgUcYMnowL3ug1wM9jb"><div class="choice-group" role="radiogroup"><ul class="radio-group-items"><li><input type="radio" id="collections-action-dialog-new" class="collections-new" name="collections" value="new" data-ga-category="collections_button" data-ga-action="click" data-ga-label="collections_radio_new"><label for="collections-action-dialog-new">Create a new collection</label></li><li><input type="radio" id="collections-action-dialog-existing" class="collections-existing" name="collections" value="existing" checked="true" data-ga-category="collections_button" data-ga-action="click" data-ga-label="collections_radio_existing"><label for="collections-action-dialog-existing">Add to an existing collection</label></li></ul></div><div class="controls-wrapper"><div class="action-panel-control-wrap new-collections-controls"><label for="collections-action-dialog-add-to-new" class="action-panel-label required-field-asterisk"> Name your collection: </label><input type="text" name="add-to-new-collection" id="collections-action-dialog-add-to-new" class="collections-action-add-to-new" pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/" maxlength="100" data-ga-category="collections_button" data-ga-action="create_collection" data-ga-label="non_favorties_collection"><div class="collections-new-name-too-long usa-input-error-message selection-validation-message"> Name must be less than 100 characters </div></div><div class="action-panel-control-wrap existing-collections-controls"><label for="collections-action-dialog-add-to-existing" class="action-panel-label"> Choose a collection: </label><select id="collections-action-dialog-add-to-existing" class="action-panel-selector collections-action-add-to-existing" data-ga-category="collections_button" data-ga-action="select_collection" data-ga-label="($('.collections-action-add-to-existing').val() === 'Favorites') ? 'Favorites' : 'non_favorites_collection'"></select><div class="collections-retry-load-on-error usa-input-error-message selection-validation-message"> Unable to load your collection due to an error<br><a href="#">Please try again</a></div></div></div><div class="action-panel-actions"><button class="action-panel-submit" type="submit" data-loading-label="Adding..." data-pinger-ignore data-ga-category="collections_button" data-ga-action="click" data-ga-label="add"> Add </button><button class="action-panel-cancel" aria-label="Close 'Add to Collections' panel" ref="linksrc=close_collections_panel" aria-controls="collections-action-panel" aria-expanded="false" data-ga-category="collections_button" data-ga-action="click" data-ga-label="cancel"> Cancel </button></div></form></div></div></div></div><button class="more-actions-button more-actions-dialog-trigger" title="Open dialog with more actions to take" ref="linksrc=more_actions_btn"></button><div class="display-options" 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disease and associated disorders" data-pinger-ignore> Alzheimer Dis Assoc Disord </button><div id="full-view-journal" class="journal-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for journal Alzheimer disease and associated disorders"><div class="title">Actions</div><div class="content"><ul class="journal-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Alzheimer+Dis+Assoc+Disord%22%5Bjour%5D&sort=date&sort_order=desc" data-href="/?term=%22Alzheimer+Dis+Assoc+Disord%22%5Bjour%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_journal_name_link&journal_abbrev=Alzheimer Dis Assoc Disord" data-ga-category="search" data-ga-action="journal_link" data-ga-label="Alzheimer Dis Assoc Disord"> Search in PubMed </a></li><li><a class="search-in-nlm-catalog-link dropdown-block-link" ref ="linksrc=search_in_nlm_catalog_link" 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href="/?term=Thomas+KR&cauthor_id=31305320" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Kelsey R Thomas">Kelsey R Thomas</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Veterans Affairs San Diego Healthcare System." href="#full-view-affiliation-1" ref="linksrc=author_aff"> 1 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Psychiatry, University of California San Diego, La Jolla, CA." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Bangen+KJ&cauthor_id=31305320" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Katherine J Bangen">Katherine J Bangen</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Veterans Affairs San Diego Healthcare System." href="#full-view-affiliation-1" ref="linksrc=author_aff"> 1 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Psychiatry, University of California San Diego, La Jolla, CA." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Weigand+AJ&cauthor_id=31305320" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Alexandra J Weigand">Alexandra J Weigand</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Veterans Affairs San Diego Healthcare System." href="#full-view-affiliation-1" ref="linksrc=author_aff"> 1 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Psychiatry, University of California San Diego, La Jolla, CA." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="San Diego State University/University of California San Diego (SDSU/UCSD) Joint Doctoral Program in Clinical Psychology, San Diego." href="#full-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Edmonds+EC&cauthor_id=31305320" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Emily C Edmonds">Emily C Edmonds</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Veterans Affairs San Diego Healthcare System." href="#full-view-affiliation-1" ref="linksrc=author_aff"> 1 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Psychiatry, University of California San Diego, La Jolla, CA." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Sundermann+E&cauthor_id=31305320" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Erin Sundermann">Erin Sundermann</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Psychiatry, University of California San Diego, La Jolla, CA." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Wong+CG&cauthor_id=31305320" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Christina G Wong">Christina G Wong</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Veterans Affairs San Diego Healthcare System." href="#full-view-affiliation-1" ref="linksrc=author_aff"> 1 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Psychiatry, University of California San Diego, La Jolla, CA." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Eppig+J&cauthor_id=31305320" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Joel Eppig">Joel Eppig</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Veterans Affairs San Diego Healthcare System." href="#full-view-affiliation-1" ref="linksrc=author_aff"> 1 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Psychiatry, University of California San Diego, La Jolla, CA." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="San Diego State University/University of California San Diego (SDSU/UCSD) Joint Doctoral Program in Clinical Psychology, San Diego." href="#full-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Werhane+ML&cauthor_id=31305320" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Madeleine L Werhane">Madeleine L Werhane</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Veterans Affairs San Diego Healthcare System." href="#full-view-affiliation-1" ref="linksrc=author_aff"> 1 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Psychiatry, University of California San Diego, La Jolla, CA." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="San Diego State University/University of California San Diego (SDSU/UCSD) Joint Doctoral Program in Clinical Psychology, San Diego." href="#full-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Delano-Wood+L&cauthor_id=31305320" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Lisa Delano-Wood">Lisa Delano-Wood</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Veterans Affairs San Diego Healthcare System." href="#full-view-affiliation-1" ref="linksrc=author_aff"> 1 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Psychiatry, University of California San Diego, La Jolla, CA." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Bondi+MW&cauthor_id=31305320" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Mark W Bondi">Mark W Bondi</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Veterans Affairs San Diego Healthcare System." href="#full-view-affiliation-1" ref="linksrc=author_aff"> 1 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Psychiatry, University of California San Diego, La Jolla, CA." href="#full-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="semicolon">; </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Alzheimer%E2%80%99s+Disease+Neuroimaging+Initiative%5BCorporate+Author%5D" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Alzheimer’s Disease Neuroimaging Initiative">Alzheimer’s Disease Neuroimaging Initiative</a></span> </div> </div> </div> <div class="short-article-details"> Affiliations <button class="more-details" id="toggle-authors" data-alt-text="Collapse" aria-controls="expanded-authors" aria-expanded="false" data-pinger-ignore data-fetch-url="/31305320/long-authors/" data-id-prefix=""> <span class="title"> Expand </span> </button> </div> <div class="extended-article-details" id="expanded-authors" aria-hidden="true"> <div class="expanded-authors" id="full-view-expanded-authors"> <div class="affiliations"> <h3 class="title"> Affiliations </h3> <ul class="item-list"> <li data-affiliation-id="full-view-affiliation-1" id="full-view-affiliation-1" ><sup class="key">1</sup> Veterans Affairs San Diego Healthcare System.</li> <li data-affiliation-id="full-view-affiliation-2" id="full-view-affiliation-2" ><sup class="key">2</sup> Department of Psychiatry, University of California San Diego, La Jolla, CA.</li> <li data-affiliation-id="full-view-affiliation-3" id="full-view-affiliation-3" ><sup class="key">3</sup> San Diego State University/University of California San Diego (SDSU/UCSD) Joint Doctoral Program in Clinical Psychology, San Diego.</li> </ul> </div> </div> </div> <ul class="identifiers" id="full-view-identifiers"> <li> <span class="identifier pubmed"> <span class="id-label"> PMID: </span> <strong class="current-id" title="PubMed ID">31305320</strong> </span> </li> <li> <span class="identifier pmc"> <span class="id-label"> PMCID: </span> <a class="id-link" target="_blank" rel="noopener" ref="linksrc=article_id_link&article_id=PMC6952586&id_type=PMC" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6952586/" data-ga-category="full_text" data-ga-action="PMCID" > PMC6952586 </a> </span> </li> <li> <span class="identifier doi"> <span class="id-label"> DOI: </span> <a class="id-link" target="_blank" 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Disord"[jour]' href="#"> Add to Search </a></li></ul></div></div></div><span class="period">. </span><span class="cit">2020 Jan-Mar;34(1):10-17.</span> </div> <span class="citation-doi"> doi: 10.1097/WAD.0000000000000332. </span> </div> <div class="expanded-authors" id="short-view-expanded-authors"> <div class="authors"> <h3 class="title"> Authors </h3> <div class="authors-list"> <span class="authors-list-item "><a class="full-name" href="/?term=Thomas+KR&cauthor_id=31305320" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Kelsey R Thomas">Kelsey R Thomas</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Veterans Affairs San Diego Healthcare System." href="#short-view-affiliation-1" ref="linksrc=author_aff"> 1 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Psychiatry, University of California San Diego, La Jolla, CA." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Bangen+KJ&cauthor_id=31305320" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Katherine J Bangen">Katherine J Bangen</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Veterans Affairs San Diego Healthcare System." href="#short-view-affiliation-1" ref="linksrc=author_aff"> 1 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Psychiatry, University of California San Diego, La Jolla, CA." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Weigand+AJ&cauthor_id=31305320" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Alexandra J Weigand">Alexandra J Weigand</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Veterans Affairs San Diego Healthcare System." href="#short-view-affiliation-1" ref="linksrc=author_aff"> 1 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Psychiatry, University of California San Diego, La Jolla, CA." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="San Diego State University/University of California San Diego (SDSU/UCSD) Joint Doctoral Program in Clinical Psychology, San Diego." href="#short-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Edmonds+EC&cauthor_id=31305320" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Emily C Edmonds">Emily C Edmonds</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Veterans Affairs San Diego Healthcare System." href="#short-view-affiliation-1" ref="linksrc=author_aff"> 1 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Psychiatry, University of California San Diego, La Jolla, CA." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Sundermann+E&cauthor_id=31305320" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Erin Sundermann">Erin Sundermann</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Psychiatry, University of California San Diego, La Jolla, CA." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Wong+CG&cauthor_id=31305320" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Christina G Wong">Christina G Wong</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Veterans Affairs San Diego Healthcare System." href="#short-view-affiliation-1" ref="linksrc=author_aff"> 1 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Psychiatry, University of California San Diego, La Jolla, CA." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Eppig+J&cauthor_id=31305320" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Joel Eppig">Joel Eppig</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Veterans Affairs San Diego Healthcare System." href="#short-view-affiliation-1" ref="linksrc=author_aff"> 1 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Psychiatry, University of California San Diego, La Jolla, CA." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="San Diego State University/University of California San Diego (SDSU/UCSD) Joint Doctoral Program in Clinical Psychology, San Diego." href="#short-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Werhane+ML&cauthor_id=31305320" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Madeleine L Werhane">Madeleine L Werhane</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Veterans Affairs San Diego Healthcare System." href="#short-view-affiliation-1" ref="linksrc=author_aff"> 1 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Psychiatry, University of California San Diego, La Jolla, CA." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="San Diego State University/University of California San Diego (SDSU/UCSD) Joint Doctoral Program in Clinical Psychology, San Diego." href="#short-view-affiliation-3" ref="linksrc=author_aff"> 3 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Delano-Wood+L&cauthor_id=31305320" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Lisa Delano-Wood">Lisa Delano-Wood</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Veterans Affairs San Diego Healthcare System." href="#short-view-affiliation-1" ref="linksrc=author_aff"> 1 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Psychiatry, University of California San Diego, La Jolla, CA." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Bondi+MW&cauthor_id=31305320" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Mark W Bondi">Mark W Bondi</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Veterans Affairs San Diego Healthcare System." href="#short-view-affiliation-1" ref="linksrc=author_aff"> 1 </a><span class="author-sup-separator"> </span><a class="affiliation-link" title="Department of Psychiatry, University of California San Diego, La Jolla, CA." href="#short-view-affiliation-2" ref="linksrc=author_aff"> 2 </a></sup><span class="semicolon">; </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Alzheimer%E2%80%99s+Disease+Neuroimaging+Initiative%5BCorporate+Author%5D" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Alzheimer’s Disease Neuroimaging Initiative">Alzheimer’s Disease Neuroimaging Initiative</a></span> </div> </div> <div class="affiliations"> <h3 class="title"> Affiliations </h3> <ul class="item-list"> <li data-affiliation-id="short-view-affiliation-1" id="short-view-affiliation-1" ><sup class="key">1</sup> Veterans Affairs San Diego Healthcare System.</li> <li data-affiliation-id="short-view-affiliation-2" id="short-view-affiliation-2" ><sup class="key">2</sup> Department of Psychiatry, University of California San Diego, La Jolla, CA.</li> <li data-affiliation-id="short-view-affiliation-3" id="short-view-affiliation-3" ><sup class="key">3</sup> San Diego State University/University of California San Diego (SDSU/UCSD) Joint Doctoral Program in Clinical Psychology, San Diego.</li> </ul> </div> </div> <ul class="identifiers" id="short-view-identifiers"> <li> <span class="identifier pubmed"> <span class="id-label"> PMID: </span> <strong class="current-id" title="PubMed ID">31305320</strong> </span> </li> <li> <span class="identifier pmc"> <span class="id-label"> PMCID: </span> <a class="id-link" target="_blank" rel="noopener" ref="linksrc=article_id_link&article_id=PMC6952586&id_type=PMC" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6952586/" data-ga-category="full_text" data-ga-action="PMCID" > PMC6952586 </a> </span> </li> <li> <span class="identifier doi"> <span class="id-label"> DOI: </span> <a class="id-link" target="_blank" rel="noopener" ref="linksrc=article_id_link&article_id=10.1097/WAD.0000000000000332&id_type=DOI" href="https://doi.org/10.1097/wad.0000000000000332" data-ga-category="full_text" data-ga-action="DOI" > 10.1097/WAD.0000000000000332 </a> </span> </li> </ul> <div class="in-clipboard-label " hidden> Item in Clipboard </div> </div> </div> </header> <div class="actions-buttons inline"><div class="inner-wrap"><button class="full-text-links-button full-text-links-dialog-trigger" title="Open dialog with full text links" ref="linksrc=full_text_links"> Full text links </button><button class="citation-button citation-dialog-trigger" aria-label="Open dialog with citation text in different styles" data-ga-category="save_share" data-ga-action="cite" data-ga-label="open" data-all-citations-url="/31305320/citations/" data-citation-style="nlm" data-pubmed-format-link="/31305320/export/"><span class="button-label">Cite</span></button><button class="more-actions-button more-actions-dialog-trigger" title="Open dialog with more actions to take" ref="linksrc=more_actions_btn"></button><div class="display-options" data-format-key="format" data-default-format-value="abstract" data-current-format-value="abstract" role="region"><button class="trigger usa-button" title="Change format" data-ga-category="display_options" data-ga-action="display_options_dialog"><span class="button-label">Display options</span></button><div class="dropdown" hidden><div class="title"> Display options </div><div class="content"><div class="format-container"><span class="option-label"> Format </span><select name="format" data-initial-value="abstract" aria-label="Display format" id="inline-actions-display-format"><option value="abstract">Abstract</option><option value="pubmed">PubMed</option><option value="pmid">PMID</option></select></div></div></div></div></div></div> <div class="abstract" id="abstract"> <h2 class="title"> Abstract </h2> <div class="abstract-content selected" id="eng-abstract"> <p> <strong class="sub-title"> Objective: </strong> 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> <p> <strong class="sub-title"> Methods: </strong> 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> <p> <strong class="sub-title"> Results: </strong> 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> <p> <strong class="sub-title"> Conclusions: </strong> 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> <p class="disclaimer" id="disclaimer"> <a href="/disclaimer/" target="_blank" ga_category="literature_resources" ga_action="disclaimer_link" ga_label="under_abstract">PubMed Disclaimer</a> </p> <div class="conflict-of-interest" id="conflict-of-interest"> <h2 class="title"> Conflict of interest statement </h2> <div class="statement"> <p xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:p1="http://pubmed.gov/pub-one">Conflicts of Interest</p> <p xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:p1="http://pubmed.gov/pub-one">Dr. Thomas reports no disclosures.</p> <p xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:p1="http://pubmed.gov/pub-one">Dr. Bangen reports no disclosures.</p> <p xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:p1="http://pubmed.gov/pub-one">Ms. Weigand reports no disclosures.</p> <p xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:p1="http://pubmed.gov/pub-one">Dr. Edmonds reports no disclosures.</p> <p xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:p1="http://pubmed.gov/pub-one">Dr. Sundermann reports no disclosures.</p> <p xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:p1="http://pubmed.gov/pub-one">Dr. Wong reports no disclosures.</p> <p xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:p1="http://pubmed.gov/pub-one">Mr. Eppig reports no disclosures.</p> <p xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:p1="http://pubmed.gov/pub-one">Ms. Werhane reports no disclosures.</p> <p xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:p1="http://pubmed.gov/pub-one">Dr. Delano-Wood reports no disclosures.</p> <p xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:p1="http://pubmed.gov/pub-one">Dr. Bondi is a consulting editor for the <italic>Journal of the International Neuropsychological Society</italic>, and serves as a paid consultant for Novartis, Eisai, and Roche pharmaceutical companies.</p> </div> </div> <div class="figures" id="figures"> <h2 class="title"> Figures </h2> <div class="figures-list" id="slides-container" itemscope itemtype="http://schema.org/ImageGallery"> <figure class="figure-item " itemscope itemtype="http://schema.org/ImageObject" itemprop="associatedMedia" data-slide-index="0" data-label-slug="figure-1"> <a class="figure-link" href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76cf/6952586/b1c15f67f726/nihms-1530734-f0001.jpg" itemprop="contentUrl" aria-describedby="figure-caption-0" role="button" data-image-width="800" data-image-height="688" data-image-alt="Figure 1:" data-pmc-id="PMC6952586" data-figure-id="F1"> <img class="figure-thumb" itemprop="thumbnail" id="article-image-0" src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76cf/6952586/ec1c6b05c713/nihms-1530734-f0001.gif" alt="Figure 1:" /> </a> <meta itemprop="width" itemtype="http://schema.org/ImageObject" content="800"> <meta itemprop="height" itemtype="http://schema.org/ImageObject" content="688"> <div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true"> <div class="caption-wrap"> <strong class="figure-label"> <p> Figure 1:. FAQ trajectories by DM and… </p> </strong> </div> </div> <div class="figure-caption-medium figure-caption-text" aria-hidden="true"> <strong class="figure-label"> <p> Figure 1:. FAQ trajectories by DM and AD risk factor. </p> </strong> <div class="figure-caption-contents"><p> Each panel shows a different… </p></div> </div> <figcaption id="figure-caption-0" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description"> <strong class="figure-label"> Figure 1:. FAQ trajectories by DM and AD risk factor. </strong> <div class="figure-caption-contents">Each panel shows a different AD risk factor: a) Objectively-defined Subtle Cognitive Decline (Obj-SCD); b) Apolipoprotein E (APOE) ε4 status; c) Total Tau (tau); d) Hyperphosphorylated Tau (p-tau); e) β-Amyloid (Aβ). Error bars represent 95% confidence interval. The light grey line shows the optimal threshold for distinguishing MCI and dementia.</div> </figcaption> </figure> </div>  <div class="pswp figures-dialog" id="figures-dialog" tabindex="-1" role="dialog" aria-hidden="true" data-image-gallery-uid="article-figures" aria-label="Figures Dialog">  <div class="pswp__bg"></div>  <div class="pswp__scroll-wrap">  <div class="pswp__container"> <div class="pswp__item"></div> <div class="pswp__item"></div> <div class="pswp__item"></div> </div>  <div class="pswp__ui pswp__ui--hidden"> <div class="pswp__top-bar">  <div class="pswp__counter"></div> <button class="pswp__button pswp__button--close" title="Close (Esc)"></button> <button class="pswp__button pswp__button--share" title="Share"></button> <button class="pswp__button pswp__button--fs" title="Toggle fullscreen"></button> <button class="pswp__button pswp__button--zoom" title="Zoom in/out"></button>   <div class="pswp__preloader"> <div class="pswp__preloader__icn"> <div class="pswp__preloader__cut"> <div class="pswp__preloader__donut"></div> </div> </div> </div> </div> <div class="pswp__share-modal pswp__share-modal--hidden pswp__single-tap"> <div class="pswp__share-tooltip"></div> </div> <button class="pswp__button pswp__button--arrow--left" title="Previous (arrow left)"> </button> <button class="pswp__button pswp__button--arrow--right" title="Next (arrow right)"> </button> <div class="pswp__caption"> <div class="pswp__caption__center"></div> </div> </div> </div> </div> <div class="figure-dialog-caption"> <div class="figure-caption-link-container"> <a class="figure-caption-link" href="#">See this image and copyright information in PMC</a> </div> <div class="figure-caption-center" data-expand-title="click to show full caption" data-collapse-title="click to hide full caption"> </div> <button class="figure-caption-toggle-btn" aria-label="show full caption" data-expand-text="show full caption" data-collapse-text="hide full caption">  </button> </div> </div> <div class="similar-articles" id="similar"> <h2 class="title"> Similar articles </h2> <ul class="articles-list" id="similar-articles-list"> <li class="full-docsum"> <div class="docsum-content" style="display:inline;"> <a class="docsum-title" href="/35996158/" ref="article_id=35996158&linksrc=similar_articles_link&ordinalpos=1" data-ga-category="similar_article" data-ga-action="35996158" data-ga-label=""> Tau levels are higher in objective subtle cognitive decline but not subjective memory complaint. </a> <div class="docsum-citation full-citation"> <span class="docsum-authors full-authors">Thomas KR, Weigand AJ, Edwards LC, Edmonds EC, Bangen KJ, Ortiz G, Walker KS, Bondi MW; Alzheimer’s Disease Neuroimaging Initiative.</span> <span class="docsum-authors short-authors">Thomas KR, et al.</span> <span class="docsum-journal-citation full-journal-citation">Alzheimers Res Ther. 2022 Aug 22;14(1):114. doi: 10.1186/s13195-022-01060-1.</span> <span class="docsum-journal-citation short-journal-citation">Alzheimers Res Ther. 2022.</span> <span class="citation-part">PMID: <span class="docsum-pmid">35996158</span></span> <span class="free-resources spaced-citation-item citation-part">Free PMC article.</span> </div> </div> </li> <li class="full-docsum"> <div class="docsum-content" style="display:inline;"> <a class="docsum-title" href="/26298664/" ref="article_id=26298664&linksrc=similar_articles_link&ordinalpos=2" data-ga-category="similar_article" data-ga-action="26298664" data-ga-label=""> Multiple Effect of APOE Genotype on Clinical and Neuroimaging Biomarkers Across Alzheimer's Disease Spectrum. </a> <div class="docsum-citation full-citation"> <span class="docsum-authors full-authors">Liu Y, Tan L, Wang HF, Liu Y, Hao XK, Tan CC, Jiang T, Liu B, Zhang DQ, Yu JT; Alzheimer’s Disease Neuroimaging Initiative.</span> <span class="docsum-authors short-authors">Liu Y, et al.</span> <span class="docsum-journal-citation full-journal-citation">Mol Neurobiol. 2016 Sep;53(7):4539-47. doi: 10.1007/s12035-015-9388-7. 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Nhu TD, Khaw KY, Tang KS, Yeong KY.</span> <span class="docsum-authors short-authors">Wee AS, et al.</span> <span class="docsum-journal-citation full-journal-citation">Curr Neuropharmacol. 2023;21(10):2036-2048. doi: 10.2174/1570159X21999221111102343.</span> <span class="docsum-journal-citation short-journal-citation">Curr Neuropharmacol. 2023.</span> <span class="citation-part">PMID: <span class="docsum-pmid">36372924</span></span> <span class="free-resources spaced-citation-item citation-part">Free PMC article.</span> <span class="publication-type spaced-citation-item citation-part">Review.</span> </div> </div> </li> </ul> <div class="actions-bar"> <a class="show-all-linked-articles" data-href="/?linkname=pubmed_pubmed_citedin&from_uid=31305320" data-ga-category="cited_by" data-ga-action="show_all" > See all "Cited by" articles </a> </div> </div> <div class="references" id="references"> <h2 class="title"> References </h2> <div id='top-references-list' class="references-lists-container"> <div class="refs-list"> <ol id="top-references-list-1" class="references-list"> <li> <ol class="references-and-notes-list"> <li class="skip-numbering" value="1"> Centers for Disease Control. National Diabetes Statistics Report, 2017 Estimates of Diabetes and Its Burden in the United States Background.; 2017. </li> </ol> </li> <li> <ol class="references-and-notes-list"> <li class="skip-numbering" value="1"> Luchsinger JA, Reitz C, Patel B, Tang M-X, Manly JJ, Mayeux R. Relation of Diabetes to Mild Cognitive Impairment. Arch Neurol. 2007;64(4):570. doi:10.1001/archneur.64.4.570. - <a class="reference-link" href="https://doi.org/10.1001/archneur.64.4.570" ref="linksrc=references_link&ordinalpos=1" data-ga-category="reference" data-ga-action="10.1001/archneur.64.4.570" > DOI </a> - <a class="reference-link" href="/17420320/" ref="linksrc=references_link&ordinalpos=2" data-ga-category="reference" data-ga-action="17420320" > PubMed </a> </li> </ol> </li> <li> <ol class="references-and-notes-list"> <li class="skip-numbering" value="1"> Palta P, Schneider ALC, Biessels GJ, Touradji P, Hill-Briggs F. Magnitude of Cognitive Dysfunction in Adults with Type 2 Diabetes: A Meta-analysis of Six Cognitive Domains and the Most Frequently Reported Neuropsychological Tests Within Domains. J Int Neuropsychol Soc. 2014;20:278–291. doi:10.1017/S1355617713001483. - <a class="reference-link" href="https://doi.org/10.1017/s1355617713001483" ref="linksrc=references_link&ordinalpos=1" data-ga-category="reference" data-ga-action="10.1017/S1355617713001483" > DOI </a> - <a class="reference-link" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC4132660/" ref="linksrc=references_link&ordinalpos=2" data-ga-category="reference" data-ga-action="PMC4132660" > PMC </a> - <a class="reference-link" href="/24555960/" ref="linksrc=references_link&ordinalpos=3" data-ga-category="reference" data-ga-action="24555960" > PubMed </a> </li> </ol> </li> <li> <ol class="references-and-notes-list"> <li class="skip-numbering" value="1"> Biessels GJ, Despa F. Cognitive decline and dementia in diabetes mellitus: mechanisms and clinical implications. Nat Rev Endocrinol. 2018;14(10):591–604. doi:10.1038/s41574-018-0048-7. - <a class="reference-link" href="https://doi.org/10.1038/s41574-018-0048-7" ref="linksrc=references_link&ordinalpos=1" data-ga-category="reference" data-ga-action="10.1038/s41574-018-0048-7" > DOI </a> - <a class="reference-link" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6397437/" ref="linksrc=references_link&ordinalpos=2" data-ga-category="reference" data-ga-action="PMC6397437" > PMC </a> - <a class="reference-link" href="/30022099/" ref="linksrc=references_link&ordinalpos=3" data-ga-category="reference" data-ga-action="30022099" > PubMed </a> </li> </ol> </li> <li> <ol class="references-and-notes-list"> <li class="skip-numbering" value="1"> 2019 Alzheimer’s disease facts and figures. Alzheimer’s Dement. 2019;15(3):321–387. doi:10.1016/j.jalz.2019.01.010. - <a class="reference-link" href="https://doi.org/10.1016/j.jalz.2019.01.010" ref="linksrc=references_link&ordinalpos=1" data-ga-category="reference" data-ga-action="10.1016/j.jalz.2019.01.010" > DOI </a> </li> </ol> </li> </ol> <div class="actions-bar"> <button class="show-all" ref="linksrc=show_all_references_link" aria-controls="top-references-list-1" data-next-page-url="/31305320/references/" data-ga-category="reference" data-ga-action="show_more" > Show all 51 references </button> </div> </div> </div> </div> <div id="mesh-terms" class="mesh-terms keywords-section"> <h2 class="title"> MeSH terms </h2> <ul class="keywords-list"><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link major" aria-label="Toggle dropdown menu for keyword Activities of Daily Living*" tabindex="0" aria-controls="keyword-actions-mesh-terms-major-0" aria-expanded="false" 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href="/?term=%22Aged%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Aged%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Aged"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Aged"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Aged" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Aged"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Aged"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Aged"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Amyloid beta-Peptides / cerebrospinal fluid" tabindex="0" aria-controls="keyword-actions-mesh-terms-2" aria-expanded="false" data-pinger-ignore> Amyloid beta-Peptides / cerebrospinal fluid </button><div id="keyword-actions-mesh-terms-2" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Amyloid beta-Peptides / cerebrospinal fluid"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Amyloid+beta-Peptides%2Fcerebrospinal+fluid%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Amyloid+beta-Peptides%2Fcerebrospinal+fluid%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Amyloid beta-Peptides/cerebrospinal fluid"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Amyloid beta-Peptides / cerebrospinal fluid"> Search in PubMed </a></li><li><a class="search-in-mesh-link 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dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Apolipoprotein E4/genetics"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Apolipoprotein E4/genetics"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link major" aria-label="Toggle dropdown menu for keyword Cognitive Dysfunction*" tabindex="0" aria-controls="keyword-actions-mesh-terms-major-4" aria-expanded="false" data-pinger-ignore> Cognitive Dysfunction* </button><div id="keyword-actions-mesh-terms-major-4" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Cognitive Dysfunction*"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Cognitive+Dysfunction%22%5BMAJR%5D&sort=date&sort_order=desc" data-href="/?term=%22Cognitive+Dysfunction%22%5BMAJR%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Cognitive Dysfunction"[MAJR]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Cognitive Dysfunction*"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Cognitive+Dysfunction" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Cognitive Dysfunction*"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Cognitive Dysfunction"[MAJR]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Cognitive Dysfunction"[MAJR]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link major" aria-label="Toggle dropdown menu for keyword Diabetes Mellitus, Type 2 / complications*" tabindex="0" aria-controls="keyword-actions-mesh-terms-major-5" aria-expanded="false" data-pinger-ignore> Diabetes Mellitus, Type 2 / complications* </button><div id="keyword-actions-mesh-terms-major-5" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Diabetes Mellitus, Type 2 / complications*"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Diabetes+Mellitus%2C+Type+2%2Fcomplications%22%5BMAJR%5D&sort=date&sort_order=desc" data-href="/?term=%22Diabetes+Mellitus%2C+Type+2%2Fcomplications%22%5BMAJR%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Diabetes Mellitus, Type 2/complications"[MAJR]" data-ga-category="search" 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aria-expanded="false" data-pinger-ignore> Female </button><div id="keyword-actions-mesh-terms-6" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Female"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Female%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Female%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Female"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Female"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Female" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Female"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Female"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Female"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Genotype" tabindex="0" aria-controls="keyword-actions-mesh-terms-7" aria-expanded="false" data-pinger-ignore> Genotype </button><div id="keyword-actions-mesh-terms-7" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Genotype"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Genotype%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Genotype%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Genotype"[MeSH]" 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id="keyword-actions-mesh-terms-major-8" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Healthy Volunteers*"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Healthy+Volunteers%22%5BMAJR%5D&sort=date&sort_order=desc" data-href="/?term=%22Healthy+Volunteers%22%5BMAJR%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Healthy Volunteers"[MAJR]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Healthy Volunteers*"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Healthy+Volunteers" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Healthy Volunteers*"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" 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Apolipoprotein E4"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Apolipoprotein+E4%22%5Bnm%5D&sort=date&sort_order=desc" data-href="/?term=%22Apolipoprotein+E4%22%5Bnm%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&keyword="Apolipoprotein E4"[nm]" data-ga-category="search" data-ga-action="substance" data-ga-label="Apolipoprotein E4"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=%22Apolipoprotein+E4%22" data-ga-category="search_mesh" data-ga-action="substance_link" data-ga-label="Apolipoprotein E4"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Apolipoprotein E4"[nm]" data-ga-category="search" data-ga-action="add_to_search" 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