Predictors of Late-life Cognitive Health in Type 1 Diabetes
1 型糖尿病晚年认知健康的预测因素
基本信息
- 批准号:8997040
- 负责人:
- 金额:$ 60.33万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2015
- 资助国家:美国
- 起止时间:2015-02-01 至 2020-01-31
- 项目状态:已结题
- 来源:
- 关键词:AdherenceAdolescentAdultAgeAge of OnsetAgingAmericanAttentionBlood GlucoseBlood VesselsCaliforniaChildClinicalCognitionCognitiveCognitive agingCohort StudiesCollectionComorbidityComputerized Medical RecordConsensus Development ConferencesDataDementiaDeteriorationDiabetes MellitusDiagnosisDiseaseElderlyEtiologyEventExhibitsExposure toGenerationsGlycosylated HemoglobinGoalsHealthHypoglycemiaImpaired cognitionIncidenceIndividualInsulinInsulin-Dependent Diabetes MellitusInterviewKnowledgeLife ExpectancyLongevityLongitudinal StudiesMatched GroupMemoryMental DepressionMicrovascular DysfunctionNon-Insulin-Dependent Diabetes MellitusPatientsPatternPerformancePopulationPreventionPublic HealthRecruitment ActivityRegistriesResourcesRiskRisk FactorsRoleSamplingSelf CareStructureTimeTranslationsagedcognitive changecognitive functioncognitive performancediabetes managementexecutive functionglycemic controlhigh riskinnovationmacrovascular diseasemiddle ageneuropsychologicalnon-diabeticpatient populationprimary care settingprocessing speedrate of changescreeningvigilance
项目摘要
DESCRIPTION (provided by applicant): Type 1 diabetes (T1D) is a complicated disease requiring constant adherence to glycemic targets and meticulous attention and vigilance of blood sugar. Although it is increasing in incidence the average life expectancy is 69 years, a 15 year increase from age 54 observed two decades ago. Concomitant with increased longevity is survival to an age at high risk of cognitive impairment and dementia both which greatly impact diabetes management and self-care. Elderly type 2 diabetes patients (T2D) have double the risk of cognitive impairment than normoglycemic individuals, yet it's unknown whether older T1D individuals are also at greater risk, and what the contributing and modulating factors are. T1D children, adolescents and middle- aged adults show deficits in certain domains of cognitive function (5), yet there's a lack of information regarding cognition in individuals aged 60 or older In contrast to elderly T2D patients, T1D have a much younger age of onset and longer duration of diabetes, increased hypoglycemia, more microvascular but less macrovascular complications, and by definition, are homogeneously treated with insulin. In the T2D population, hypoglycemic episodes, depression and microvascular comorbidities are established risk factors for cognitive impairment. Yet, it is unknown how these factors (2-3 times more common in T1D) influence cognitive aging in elderly T1D populations. We propose an innovative longitudinal study of cognitive aging in elderly T1D which will close the gap in knowledge regarding late-life cognitive function in this rapidly increasing group. We will exploit the exquisite data resources o the Kaiser Permanente of Northern California (KPNC) Diabetes Registry. The registry comprises over 147,000 elderly individuals with diabetes aged 60 and older (>7000 potential individuals with type 1 diabetes) from which to sample and prospectively investigate neuropsychological function and the profile of cognitive changes in this understudied and unique group. We will recruit 1200 patients aged 60-80 years (600 T1D and 600 without diabetes) and follow them over 4 years in a matched cohort study. At baseline and 36 months later a detailed neuropsychological battery will be given, and supplemented by annual phone administered collection of global cognition. Our goals are the following:1). Determine baseline and three year changes in global and domain specific cognition in elderly type 1 diabetes patients in comparison to a matched group of elderly individuals without diabetes, 2.) Characterize the role of glycemic control and vascular complications on cognitive change in the context of type 1 diabetes, and 3.) Evaluate the interaction of depression and type 1 diabetes on cognitive changes. This would be the first longitudinal study of cognitive aging in type 1 diabetes and has profound clinical implications for glycemic treatment targets and self-care. It will also provide a
mechanistic framework for understanding glycemic and insulin related mechanisms in prevention of cognitive impairment and dementia
描述(由申请人提供):1 型糖尿病 (T1D) 是一种复杂的疾病,需要持续遵守血糖目标并对血糖保持密切关注和警惕。尽管发病率不断上升,但平均预期寿命为 69 岁,比 20 年前的 54 岁增加了 15 岁。与寿命延长相伴随的是认知障碍和痴呆症高风险年龄的生存,这两者都极大地影响糖尿病管理和自我护理。老年 2 型糖尿病患者 (T2D) 出现认知障碍的风险是血糖正常者的两倍,但尚不清楚老年 T1D 患者是否也面临更大的风险,以及影响因素和调节因素是什么。 T1D 儿童、青少年和中年人在某些认知功能领域表现出缺陷 (5),但缺乏有关 60 岁或以上个体认知功能的信息 与老年 T2D 患者相比,T1D 的发病年龄要小得多糖尿病病程较长、低血糖增加、微血管并发症较多但大血管并发症较少,根据定义,均用胰岛素治疗。在 T2D 人群中,低血糖发作、抑郁和微血管合并症是认知障碍的危险因素。然而,尚不清楚这些因素(在 T1D 中常见 2-3 倍)如何影响老年 T1D 人群的认知衰老。我们提出了一项针对老年 T1D 认知衰老的创新纵向研究,这将缩小这一快速增长群体中晚年认知功能的知识差距。我们将利用北加州凯撒医疗机构 (KPNC) 糖尿病登记处的精致数据资源。该登记册由超过 147,000 名 60 岁及以上患有糖尿病的老年患者(> 7000 名潜在的 1 型糖尿病患者)组成,从中抽取样本并前瞻性调查这个尚未得到充分研究的独特群体的神经心理功能和认知变化概况。我们将招募 1200 名 60-80 岁患者(600 名 T1D 患者和 600 名非糖尿病患者),并在一项匹配队列研究中对他们进行 4 年多的跟踪。在基线和 36 个月后,将提供详细的神经心理学电池,并通过年度电话管理的全球认知收集进行补充。我们的目标如下:1)。确定老年 1 型糖尿病患者与匹配的非糖尿病老年个体相比,其整体和领域特定认知的基线和三年变化,2.) 描述血糖控制和血管并发症在 1 型糖尿病背景下认知变化的作用1 型糖尿病,以及 3.) 评估抑郁症和 1 型糖尿病对认知变化的相互作用。这将是第一个针对 1 型糖尿病认知衰老的纵向研究,对血糖治疗目标和自我护理具有深远的临床意义。它还将提供一个
了解预防认知障碍和痴呆的血糖和胰岛素相关机制的机制框架
项目成果
期刊论文数量(0)
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Rachel A Whitmer其他文献
Rachel A Whitmer的其他文献
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$ 60.33万 - 项目类别:
Predictors of Late-life Cognitive Health in Type 1 Diabetes
1 型糖尿病晚年认知健康的预测因素
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- 资助金额:
$ 60.33万 - 项目类别:
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