Cardiometabolic Risk Factors and Domain-Specific Cognitive Function in Prediabetes and Type 2 Diabetes

Type 2 Diabetes and Cognitive Dysfunction: Cardiorespiratory Fitness and Physical Activity Matters

Cognitive performance in people with Type 2 diabetes mellitus and their correlation with physical activity (PA)/fitness level and mood are examined and individuals with T2DM showed at least two to three times more frequent cognitive performances more than 1 SD below norm as compared with controls.

Cognitive Impairment in People with Type 2 Diabetes Mellitus: Associations with Inflammatory and Vascular Markers

Background Type 2 diabetes mellitus (T2DM) is associated with metabolic, vascular and cognitive complications. Although mild cognitive impairment (MCI) is increasingly recognised in T2DM, its relationship with inflammatory and vascular markers remains underexplored in India. Purpose This study investigated the association between high-sensitivity C-reactive protein (hs-CRP), carotid intima-media thickness (CIMT) and cognitive status in individuals with T2DM. Methods This cross-sectional study included 117 adults aged 40–65 years with T2DM of at least 5 years’ duration, recruited from a tertiary care hospital in Mysuru. Cognitive function was assessed using the Saint Louis University Mental Status Scale. Clinical, anthropometric, biochemical and vascular parameters, including hs-CRP and CIMT, were measured. Group comparisons and correlation analyses were conducted. Results MCI was present in 47.9% of participants. Education level was significantly associated with cognitive status (p = .001). Participants with MCI exhibited higher hs-CRP levels (p = .007) and greater CIMT (p = .001) compared to those with normal cognition. Correlation analyses demonstrated negative associations between SLUMS scores, hs-CRP and CIMT. Receiver operating characteristic analysis indicated fair predictive value for hs-CRP (AUC = 0.64) and CIMT (AUC = 0.70). Conclusion Lower educational attainment, higher hs-CRP levels and greater CIMT were associated with MCI among individuals with T2DM. These findings suggest that inflammatory and vascular markers may be useful in identifying individuals at greater risk of cognitive impairment. However, longitudinal studies are required to determine temporal and causal relationships.

Exploring the threshold association between cardiometabolic index and cognitive function in U.S. adults aged ≥ 60 years

It is suggested that higher CMI may indicate a greater risk of cognitive decline in older adults, and diabetes status significantly modified the CMI–GCF relationship.

Improving cognition through lifestyle-induced remission of type 2 diabetes: findings from DIABEPIC-2.

Associations of domain-specific cognitive function with all-cause mortality over 11 years: the Australian Diabetes, Obesity and Lifestyle (AusDiab) study.

BACKGROUND Poor cognitive function is associated with increased mortality; however, whether these associations are consistent across different cognitive domains remains incompletely understood. METHODS We examined associations between cognitive function and all-cause mortality in a population-based cohort of Australian adults (N = 4561, median age = 60.0 years). In addition to global cognitive function (Mini-Mental State Examination [MMSE]) and premorbid verbal ability, participants underwent clinical assessments targeting the specific cognitive domains of processing speed and memory. Cox proportional hazards models with age as the time scale estimated hazard ratios (HR) for all-cause mortality per 1-standard deviation (SD) increase in cognitive scores. Analyses were adjusted for sociodemographic (including education), lifestyle, and clinical factors. RESULTS In this cohort with predominantly normal MMSE scores (98%), followed for a median of 11.3 years, 566 deaths occurred. Cognitive function was associated with lower mortality across most domains, as evidenced by 22% reduced mortality risk per 1-SD increase in global cognitive function (HR 0.78, 95% CI [0.67, 0.90]), 32% per 1-SD increase in processing speed (HR 0.68, [0.59, 0.78]) and 20% per 1-SD increase in memory (HR 0.80, [0.71, 0.91]), in fully adjusted models. Premorbid verbal ability was not associated with mortality (HR 0.92, [0.83, 1.02]). Associations were similar in men and women, and robust across sensitivity analyses. CONCLUSIONS Processing speed and memory were independently associated with mortality after covariate adjustment. The presence of these associations in a cohort with mostly preserved cognitive function underscores the potential of domain-specific cognitive measures to serve as indirect prognostic markers of mortality and to inform risk stratification.

Joint Association of Triglyceride-Glucose Index and a Body Shape Index With Risk of Cardiovascular Disease Among Adults With Prediabetes.

BACKGROUND Individuals with prediabetes have a higher cardiovascular disease (CVD) risk than those with normoglycemia. Identifying high-risk subgroups is crucial for targeted prevention. While the triglyceride-glucose index (TyG) and a body shape index (ABSI) are independently linked to CVD risk, their combined utility in individuals with prediabetes remains unexplored. This study aimed to investigate whether concurrent high TyG and ABSI confer an additive CVD risk in this population. METHODS We analyzed 6833 UK Biobank participants with prediabetes and no baseline CVD. Cox proportional hazards models were used to assess the associations between TyG, ABSI, and CVD incidence, adjusting for sociodemographic and metabolic confounders. Predictive performance was evaluated using the area under the curve (AUC) of receiver operating characteristic curves. RESULTS Over a median 9.5-year follow-up, 840 participants developed CVD. Elevated TyG (hazard ratio [HR] = 1.09, 95% confidence interval [CI]: 1.01-1.25) and the highest ABSI quartile (HR = 1.54, 95% CI: 1.22-1.94) showed independent associations with CVD risk. Combined high TyG/high ABSI conferred an additive risk (HR = 1.65, 95% CI: 1.24-2.20), an effect more pronounced in hypertensive participants than in normotensive individuals (p for interaction = 0.018). The dual-marker method showed better discriminative performance for CVD (AUC = 0.685) than TyG or ABSI alone (TyG: 0.661; ABSI: 0.608; DeLong test p < 0.001). CONCLUSION The joint elevation of TyG and ABSI identifies individuals with prediabetes at higher CVD risk independent of conventional indicators, especially within hypertensive subgroups, enabling targeted monitoring and intervention to alleviate the CVD burden.