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NIDDM and Blood Pressure as Risk Factors for Poor Cognitive Performance: The Framingham Study
Abstract
OBJECTIVE: To determine if NIDDM and blood pressure are risk factors for poor cognitive performance and if history and duration of NIDDM and blood pressure interact such that the risk of poor performance is greater for subjects with both NIDDM and hypertension. RESEARCH DESIGN AND METHODS: We used a large prospective cohort sample with 187 NIDDM subjects and 1,624 nondiabetic subjects who were followed for 28–30 years. Cognitive function was assessed using eight tests of learning, memory, visual organization, verbal fluency attention, concept formation, and abstract reasoning. A composite score was also calculated. Odds ratios were used to estimate the relative risk of performing below the lower 25th percentile of z scores on these tests. RESULTS: NIDDM and blood pressure interacted such that diagnosis and duration of NIDDM were associated with greater risk of poor performance on tests of visual memory and on the composite score for hypertensive subjects. Duration of NIDDM was associated with increased risk for poor performance on tests of verbal memory and concept formation. Insulin-treated NIDDM subjects were at higher risk for poor cognitive performance than those NIDDM subjects treated with oral agents or diet. Blood pressure level was associated independently with a measure of verbal fluency. CONCLUSIONS: History and duration of NIDDM and high blood pressure are significant risk factors for poor cognitive performance. Hypertensive people with NIDDM are at greatest risk for poor performance on tests measuring visual organization and memory.
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“In the Framingham Study, 2,123 subjects aged 55 to 88 completed a neuropsychological test battery during either the 14th or 15th biennial examination. People with diabetes status were more likely to achieve scores below the 25th percentile on most tests than were non-diabetic individuals.”
From Cognitive decline and dementia in diabetes—systematic overview of prospective observational studies (2005) · cites this paper as [71]
In the citing paper
“They are also supported by the large Framingham study [71] and the Adult Health Study [72].”
From Cognitive decline and dementia in diabetes—systematic overview of prospective observational studies (2005) · cites this paper as [71]
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Midlife cardiovascular risk factors and risk of dementia in late life
Whitmer, R. A., Sidney, S., Selby, J., Johnston, S. C., & Yaffe, K. (2005) · Neurology · doi:10.1212/01.wnl.0000149519.47454.f2 · Cited by 1,238
Cognitive decline and dementia in diabetes—systematic overview of prospective observational studies
Cukierman, T., Gerstein, H. C., & Williamson, J. D. (2005) · Diabetologia · doi:10.1007/s00125-005-0023-4 · Cited by 1,049
“They are also supported by the large Framingham study [71] and the Adult Health Study [72].”
Cardiovascular risk factors and cognitive decline in middle-aged adults
Knopman, D., Boland, L. L., Mosley, T., Howard, G., Liao, D., Szklo, M., McGovern, P., & Folsom, A. R. (2001) · Neurology · doi:10.1212/wnl.56.1.42 · Cited by 883
Insulin and neurodegenerative disease: shared and specific mechanisms
Craft, S., & Stennis Watson, G. (2004) · The Lancet Neurology · doi:10.1016/s1474-4422(04)00681-7 · Cited by 830
Seeman, T. E., Lusignolo, T. M., Albert, M., & Berkman, L. (2001) · Health Psychology · doi:10.1037/0278-6133.20.4.243 · Cited by 855
Metadata
- Authors
- Elias, P. K., Elias, M. F., D'Agostino, R. B., Cupples, L. A., Wilson, P. W., Silbershatz, H., & Wolf, P. A.
- Affiliations
- Boston University (US)
- University of Maine (US)
- Department of Mathematics, Statistics and Consulting Unit, Boston University Boston, Massachusetts
- National Heart, Lung, and Blood Institute (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 1997-09-01
- Volume
- 20
- Issue
- 9
- Pages
- 1388-1395
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2057702509
- Cited by
- 368
- References
- 0
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 3 · 2022: 15 · 2021: 6 · 2020: 10 · 2019: 8 · 2018: 7 · 2017: 13 · 2016: 17 · 2015: 13 · 2014: 20 · 2013: 21 · 2012: 14
- FWCI
- 5.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (5-R37-AG03055-14, R37AG003055, 2-R01-AG08122-07, R01-AG0646-02, R01AG008122)
- National Institute of Neurological Disorders and Stroke
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, hypertension, blood pressure, cognitive performance, cognitive decline, risk factors, diabetes duration, insulin therapy, oral antidiabetic drugs, visual memory, verbal memory, verbal fluency, Framingham Heart Study
- MeSH terms
- Aged, Aged, 80 and over, Blood Pressure, Cognition, Cognition Disorders, Diabetes Mellitus, Type 2, Female, Humans, Male, Middle Aged, Prospective Studies, Reference Values, Risk Factors, Cohort Studies, Confidence Intervals, Odds Ratio
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