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. 2022 Nov;56(10):5917-5930.
doi: 10.1111/ejn.15821. Epub 2022 Sep 30.

Self-reported diabetes is associated with allocentric spatial processing in the European Prevention of Alzheimer's Dementia Longitudinal Cohort Study

Sarah Gregory  1 , Kaj Blennow  2   3 , Natalie Z M Homer  4 , Craig W Ritchie  1 , Graciela Muniz-Terrera  1   5
Affiliations

Self-reported diabetes is associated with allocentric spatial processing in the European Prevention of Alzheimer's Dementia Longitudinal Cohort Study

Sarah Gregory et al. Eur J Neurosci. 2022 Nov.

Abstract

Type 2 diabetes is a robust predictor of cognitive impairment. Impairment in allocentric processing may help identify those at increased risk for Alzheimer's disease dementia. The objective of this study was to investigate the performance of participants with and without diabetes on a task of allocentric spatial processing. This was a cross-sectional secondary data analysis study using baseline data from the European Prevention of Alzheimer's Dementia Longitudinal Cohort Study (EPAD LCS). Participants were aged 50 years and above and were free of dementia at baseline. Participants with no missing data on the variables of interest were included in this study. Our exposure variable was diabetes reported in the medical history. Our primary outcome was the Four Mountains Test (4MT), a novel task of allocentric processing. Covariates included demographics (age, sex, family history of dementia and years of education), APOEε4 carrier status, cognitive status (Clinical Dementia Rating scale), cerebrospinal fluid phosphorylated tau and amyloid-beta 1-42. Of 1324 participants (mean age = 65.95 (±7.45)), 90 had diabetes. Participants with diabetes scored 8.32 (±2.32) on the 4MT compared with 9.24 (±2.60) for participants without diabetes. In a univariate model, diabetes was significantly associated with worse 4MT total scores (β = -.92, p = .001), remaining significant in a fully adjusted model (β = -.64, p = .01). Cerebrospinal fluid phosphorylated tau was significantly higher in participants with diabetes compared with those without. Novel cognitive tests, such as the 4MT, may be appropriate to identify early cognitive changes in this high-risk group. Identifying those at greatest risk for future neurodegeneration is key to prevention efforts.

Keywords: Alzheimer's disease; cohort study; diabetes; prevention; risk factor.

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Conflict of interest statement

SG previously received salary from the EU/EFPIA grant that was used to fund the data collection (no. 115736) and holds a research grant from the Scottish Neurological Research Fund, which uses the Four Mountains Test as the primary outcome measure. KB has received consulting fees from Abcam, Axon, Biogen, JOMDD/Shimadzu, Julius Clinical, Lilly, MagQu, Novartis, Roche Diagnostics and Siemens Healthineers and is the co‐founder of Brain Biomarker Solutions (Gothenburg, Sweden). CWR has received consulting fees from Biogen, Eisai, MSD, Actinogen, Roche and Eli Lilly and speaker fees from Roche and Eisai. CWR sits on an NIHR data safety monitoring board and is on an advisory board for Roche Diagnostics. CWR is an unpaid chair of the Brain Health Clinic Consortium (sponsored by Biogen), unpaid chair of the Scottish Dementia Research Consortium and director of Brain Health Scotland. NZMH and GMT have no conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Density of Four Mountains Test (4MT) scores by diabetic status
FIGURE 2
FIGURE 2
Density of phosphorylated tau‐181 (pTau181) concentration by diabetic status
FIGURE 3
FIGURE 3
Density of amyloid‐beta 1–42 (Aβ1–42) concentration by diabetic status
See this image and copyright information in PMC

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