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Blood pressure, aortic stiffness, hemodynamics, and cognition in twin pairs discordant for type 2 diabetes


Karayiannis, C and Moran, C and Sharman, JE and Beare, R and Quinn, SJ and Phan, TG and Wood, AG and Thrift, AG and Wang, WC and Srikanth, V, Blood pressure, aortic stiffness, hemodynamics, and cognition in twin pairs discordant for type 2 diabetes, Journal of Alzheimer's Disease, 71, (3) pp. 763-773. ISSN 1387-2877 (2019) [Refereed Article]

Copyright Statement

Copyright 2019 ISO Press and the authors

DOI: doi:10.3233/JAD-190319


Background: Type 2 diabetes (T2D) is associated with an increased risk of cognitive impairment and dementia with poorly understood underlying mechanisms.

Objective: We examined the role of blood pressure (BP), aortic stiffness, and hemodynamics in this association.

Methods: Cross-sectional sample of late middle-aged twins discordant for T2D from the Australian Twin Registry. Measurements included neuropsychological battery and brain MRI including arterial spin labelling (ASL) to measure cerebral perfusion. Mobil-o-Graph devices were used to non-invasively obtain 24-hour BP, aortic stiffness, and hemodynamic measures. Using mixed modelling, we studied associations of T2D with cognition, MRI measures, BP, aortic stiffness, and hemodynamics.

Results: There were 23 twin pairs with mean age 63.7 (SD = 6.1) years. T2D (β=-0.45, p < 0.001) and age (β=-0.05, p = 0.022) were independently associated with poorer attention but not with memory or perceptual speed. T2D was associated with reduced nocturnal central systolic BP dipping (β=-3.79, p = 0.027), but not with BP, aortic stiffness, cerebral perfusion, or other hemodynamic measures. There was a statistically significant interaction between T2D and central systolic BP dipping in predicting attention scores (both p < 0.05 for the interaction term) whereby there was a positive association between BP dipping and attention scores in those with T2D, but not in those without T2D.

Conclusion: We found an association between T2D and reduced nocturnal central systolic dipping, but not with any other measures of BP, stiffness or hemodynamic measures. Further study of the role of nocturnal central BP dipping in the association between T2D and cognitive impairment may help identify potential mechanisms.

Item Details

Item Type:Refereed Article
Keywords:blood pressure, cerebrovascular circulation, cognitive dysfunction, dementia, hemodynamics, type 2 diabetes mellitus, vascular stiffness
Research Division:Biomedical and Clinical Sciences
Research Group:Neurosciences
Research Field:Neurology and neuromuscular diseases
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Sharman, JE (Professor James Sharman)
UTAS Author:Srikanth, V (Dr Velandai Srikanth)
ID Code:137268
Year Published:2019
Web of Science® Times Cited:3
Deposited By:Menzies Institute for Medical Research
Deposited On:2020-02-06
Last Modified:2020-03-27

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