Abstract
BackgroundType 2 diabetes mellitus is associated with risk of congestive heart failure (CHF), cognitive dysfunction and depression. CHF itself is linked both to poor cognition and depression. The ventricular N-terminal pro-brain natriuretic peptide (NT-proBNP) is a marker of CHF, suggesting potential as a marker for cognitive impairment and/or depression. This was tested in the Edinburgh Type 2 Diabetes Study (ET2DS).Methodology and Principal FindingsCross-sectional analysis of 1066 men and women aged 60–75 with type 2 diabetes. Results from seven neuropsychological tests were combined in a standardised general cognitive ability factor, ‘g’. A vocabulary-based test estimated pre-morbid cognitive ability. The Hospital Anxiety and Depression Scale (HADS) assessed possible depression. After adjustment for age and sex, raised plasma NT-proBNP was weakly associated with lower ‘g’ and higher depression scores (ß −0.09, 95% CI −0.13 to −0.03, p = 0.004 and ß 0.08, 95% CI 0.04 to 0.12, p<0.001, respectively). Comparing extreme quintiles of NT-proBNP, subjects in the highest quintile were more likely to have reduced cognitive ability (within the lowest tertile of ‘g’) and ‘possible’ depression (HADS depression ≥8) (OR 1.80; 95% CI: 1.20, 2.70; p = 0.005 and OR 2.18; 95% CI: 1.28, 3.71; p = 0.004, respectively). Associations persisted when pre-morbid ability was adjusted for, but as expected were no longer statistically significant following the adjustment for diabetes-related and vascular co-variates (β −0.02, 95% CI −0.07 to 0.03, p>0.05 for ‘g’; β 0.03, 95% CI −0.02 to 0.07, p>0.05 for depression scores).ConclusionRaised plasma NT-proBNP was weakly but statistically significantly associated with poorer cognitive function and depression. The prospective phases of the ET2DS will help determine whether or not NT-proBNP can be considered a risk marker for subsequent cognitive impairment and incident depression and whether it provides additional information over and above traditional risk factors for these conditions.
Highlights
People with type 2 diabetes are at around 1.5 to 2.5-fold increased risk of developing dementia [1,2], a disorder involving progressive cognitive, behavioural and motor deficits
The present study aims to assess the association of NTproBNP with level of cognitive ability, with level of ability relative to estimated peak pre-morbid ability, and with depressive symptoms, in a large, representative cohort of elderly patients with the full spectrum of severity of type 2 diabetes
Principal component analysis revealed that all seven cognitive tests (LM, Faces, Matrix Reasoning test (MR), Digit Symbol Coding (DSC), Trail-Making Test B (TMT-B), Letter Number Sequencing (LNS), Borkowski Verbal Fluency Test (BVFT)) could be captured by the single standardised factor, ‘g’
Summary
People with type 2 diabetes are at around 1.5 to 2.5-fold increased risk of developing dementia [1,2], a disorder involving progressive cognitive, behavioural and motor deficits. Type 2 diabetes is associated with an increased risk of age-associated cognitive decline, short of frank dementia [3], and with depression [4,5], a condition closely related to cognitive dysfunction. The underlying mechanisms responsible for these links are unclear. Type 2 diabetes mellitus is associated with risk of congestive heart failure (CHF), cognitive dysfunction and depression. CHF itself is linked both to poor cognition and depression. The ventricular N-terminal pro-brain natriuretic peptide (NT-proBNP) is a marker of CHF, suggesting potential as a marker for cognitive impairment and/or depression. This was tested in the Edinburgh Type 2 Diabetes Study (ET2DS)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
