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Project 2:

Diabetes Control and Memory Impairment in Minority Elderly

 

Diabetes Control and Memory Impairment in Minority Elderly (DIAMEM) is lead by Dr. Luchsinger, director of the NOCEMHD.

 

Memory impairment and its most severe manifestation, Alzheimer's disease (AD), are some of the most pressing public health problems of our generation. There is no known prevention or cure for AD. Work by Dr. Luchsinger has demonstrated that Type 2 diabetes and hyperinsulinemia are the most important risk factors for memory impairment and AD in the community of Northern Manhattan. However, modifiers of the risk of memory impairment and AD among persons with type 2 diabetes are not known. Furthermore, both type 2 diabetes and memory impairment are twice as common in elderly Blacks and Latinos compared to Whites. Thus, memory impairment in person with diabetes is a pressing minority health issue.

The overall goal of this project is to establish how diabetes control is related to the risk of memory impairment. The primary aim is to relate in a prospective study glycemic control measured by hemoglobin A1c to memory decline. We will explore other predictors as a secondary aim: blood pressure, lipids, insulin resistance, and inflammation. The study has already recruited over 600 persons who are followed annually.

The cohort for this study was recruited from an existing randomized trial of telemedicine in diabetes control (Clinicaltrials.gov identifier NCT00271739) funded by the Center for Medicare and Medicaid Services (CMS). Recruitment of this cohort was initially supported by the Fidelity Foundation, and the Alzheimer’s Association.

Data collected in this study will help clarify whether tight glycemic control modifies the risk of memory impairment among minority elders with diabetes, identify additional factors that may be amenable to intervention, and help clarify the mechanisms of memory impairment among persons with diabetes.

Publications

Luchsinger JA, Palmas W, Teresi JA, Silver S, Kong J, Eimicke JP, Weinstock RS, Shea S. Improved diabetes control in the elderly delays global cognitive decline. J Nutr Health Aging. 2011 Jun;15(6):445-9. PubMed PMID: 21623465; PubMed Central PMCID: PMC3328757.

Noble JM, Manly JJ, Schupf N, Tang MX, Luchsinger JA. Type 2 diabetes and ethnic disparities in cognitive impairment. Ethn Dis. 2012 Winter;22(1):38-44. PubMed PMID: 22774307; PubMed Central PMCID: PMC3398739.

Singer JR, Palmas W, Teresi J, Weinstock R, Shea S, Luchsinger JA. Adiponectin and all-cause mortality in elderly people with type 2 diabetes. Diabetes Care. 2012 Sep;35(9):1858-63. doi: 10.2337/dc11-2215. Epub 2012 Jul 6. PubMed PMID: 22773703; PubMed Central PMCID: PMC3424994.

Palta P, Golden SH, Teresi J, Palmas W, Weinstock RS, Shea S, Manly JJ, Luchsinger JA. Mild cognitive dysfunction does not affect diabetes mellitus control in minority elderly adults. J Am Geriatr Soc. 2014 Dec;62(12):2363-8. doi: 10.1111/jgs.13129. Epub 2014 Nov 29. PubMed PMID: 25439094; PubMed Central PMCID: PMC4288580.

Palta P, Golden SH, Teresi JA, Palmas W, Trief P, Weinstock RS, Shea S, Manly JJ, Luchsinger JA. Depression is not associated with diabetes control in minority elderly. J Diabetes Complications. 2014 Nov-Dec;28(6):798-804. doi: 10.1016/j.jdiacomp.2014.06.014. Epub 2014 Jul 1. PubMed PMID: 25156987; PubMed Central PMCID: PMC4310458.

Fitzpatrick AL, Rapp SR, Luchsinger J, Hill-Briggs F, Alonso A, Gottesman R, Lee H, Carnethon M, Liu K, Williams K, Sharrett AR, Frazier-Wood A, Lyketsos C, Seeman T. Sociodemographic Correlates of Cognition in the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Geriatr Psychiatry. 2015 Jan 20. pii: S1064-7481(15)00057-3. doi: 10.1016/j.jagp.2015.01.003. [Epub ahead of print] PubMed PMID: 25704999.

Schneider BC, Gross AL, Bangen KJ, Skinner JC, Benitez A, Glymour MM, Sachs BC, A Shih R, Sisco S, Manly JJ, Luchsinger JA. Association of Vascular Risk Factors With Cognition in a Multiethnic Sample. J Gerontol B Psychol Sci Soc Sci. 2014 May 12. [Epub ahead of print] PubMed PMID: 24821298.

 
 
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