Caitlin W Hicks1, Dan Wang2, Andrea L C Schneider3, Michelle C Johansen4, Rebecca F Gottesman5, Kunihiro Matsushita2, Josef Coresh2, B Gwen Windham6, Elizabeth Selvin2. 1. Division of Vascular Surgery and Endovascular Therapy, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, chicks11@jhmi.edu. 2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. 3. Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 4. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 5. National Institute of Neurological Disorders and Stroke Intramural Research Program, Bethesda, Maryland, USA. 6. Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA.
Abstract
INTRODUCTION: The aim of this study was to assess the association of peripheral neuropathy (PN) as defined by monofilament insensitivity with mild cognitive impairment (MCI) and dementia in older adults with and without diabetes. METHODS: We conducted a cross-sectional analysis of 3,362 Black and White participants in the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS) who underwent monofilament testing at visit 6 (2016-2017, age 71-94 years). Participants' cognitive status was classified by an adjudication committee as cognitively normal, MCI, or dementia after completing a comprehensive battery of neurocognitive assessments. We used logistic regression to evaluate the association of PN with MCI or dementia overall and stratified by diabetes status after adjusting for traditional dementia risk factors. We also compared age-adjusted brain MRI measures among a subset (N = 1,095) of participants with versus without PN. RESULTS: Overall, the prevalence of MCI (21.9% vs. 16.7%) and dementia (7.8% vs. 3.9%) were higher among participants with versus without PN (both p < 0.05). After adjustment, PN was positively associated with MCI or dementia in the overall study population (OR 1.45, 95% CI 1.23, 1.73). Results were similar by diabetes status (diabetes: OR 1.38, 95% CI 1.03-1.87; no diabetes: OR 1.48, 95% CI 1.20-1.83; p-for-interaction = 0.46). Age-adjusted total and lobar brain volumes were significantly lower in participants with versus without PN (both, p < 0.05). DISCUSSION/ CONCLUSIONS: PN as defined by monofilament insensitivity was associated with cognitive status independent of vascular risk factors and regardless of diabetes status. Our findings support a connection between PN and cognitive impairment, even in the absence of diabetes.
INTRODUCTION: The aim of this study was to assess the association of peripheral neuropathy (PN) as defined by monofilament insensitivity with mild cognitive impairment (MCI) and dementia in older adults with and without diabetes. METHODS: We conducted a cross-sectional analysis of 3,362 Black and White participants in the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS) who underwent monofilament testing at visit 6 (2016-2017, age 71-94 years). Participants' cognitive status was classified by an adjudication committee as cognitively normal, MCI, or dementia after completing a comprehensive battery of neurocognitive assessments. We used logistic regression to evaluate the association of PN with MCI or dementia overall and stratified by diabetes status after adjusting for traditional dementia risk factors. We also compared age-adjusted brain MRI measures among a subset (N = 1,095) of participants with versus without PN. RESULTS: Overall, the prevalence of MCI (21.9% vs. 16.7%) and dementia (7.8% vs. 3.9%) were higher among participants with versus without PN (both p < 0.05). After adjustment, PN was positively associated with MCI or dementia in the overall study population (OR 1.45, 95% CI 1.23, 1.73). Results were similar by diabetes status (diabetes: OR 1.38, 95% CI 1.03-1.87; no diabetes: OR 1.48, 95% CI 1.20-1.83; p-for-interaction = 0.46). Age-adjusted total and lobar brain volumes were significantly lower in participants with versus without PN (both, p < 0.05). DISCUSSION/ CONCLUSIONS: PN as defined by monofilament insensitivity was associated with cognitive status independent of vascular risk factors and regardless of diabetes status. Our findings support a connection between PN and cognitive impairment, even in the absence of diabetes.
Authors: Bruce Fischl; David H Salat; Evelina Busa; Marilyn Albert; Megan Dieterich; Christian Haselgrove; Andre van der Kouwe; Ron Killiany; David Kennedy; Shuna Klaveness; Albert Montillo; Nikos Makris; Bruce Rosen; Anders M Dale Journal: Neuron Date: 2002-01-31 Impact factor: 17.173
Authors: Guy M McKhann; David S Knopman; Howard Chertkow; Bradley T Hyman; Clifford R Jack; Claudia H Kawas; William E Klunk; Walter J Koroshetz; Jennifer J Manly; Richard Mayeux; Richard C Mohs; John C Morris; Martin N Rossor; Philip Scheltens; Maria C Carrillo; Bill Thies; Sandra Weintraub; Creighton H Phelps Journal: Alzheimers Dement Date: 2011-04-21 Impact factor: 21.566
Authors: Edward W Gregg; Qiuping Gu; Desmond Williams; Nathalie de Rekeneire; Yiling J Cheng; Linda Geiss; Michael Engelgau Journal: Diabetes Res Clin Pract Date: 2007-02-15 Impact factor: 5.602
Authors: T H Mosley; D S Knopman; D J Catellier; N Bryan; R G Hutchinson; C A Grothues; A R Folsom; L S Cooper; G L Burke; D Liao; M Szklo Journal: Neurology Date: 2005-06-28 Impact factor: 9.910
Authors: Bin Liu; Hui-Ming Gao; Jiz-Yuh Wang; Gwang-Ho Jeohn; Cynthia L Cooper; Jau-Shyong Hong Journal: Ann N Y Acad Sci Date: 2002-05 Impact factor: 5.691
Authors: K Kantarci; S D Weigand; S A Przybelski; M M Shiung; J L Whitwell; S Negash; D S Knopman; B F Boeve; P C O'Brien; R C Petersen; C R Jack Journal: Neurology Date: 2009-04-28 Impact factor: 9.910