INS NYC 2024 Program

Poster	Poster Session 08 Program Schedule 02/16/2024 01:45 pm - 03:00 pm Room: Shubert Complex (Posters 1-60) Poster Session 08: Cognition \| Cognitive Reserve Variables Final Abstract #42 Associations of Cerebral Small Vessel Disease with Cognitive Functions and Subjective Work Ability in Middle-Aged Adults with Type 1 Diabetes Iiris Kyläheiko, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki; Folkhälsan Institute of Genetics, Folkhälsan Research Center; Research Program for Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland Aleksi Tarkkonen, HUS Medical Imaging Center, Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland Juha Martola, HUS Medical Imaging Center, Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland Teemu Paajanen, Work Ability and Working Careers Unit, Finnish Institute of Occupational Health, Helsinki, Finland Jussi Virkkala, Department of Neurophysiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland Per-Henrik Groop, Folkhälsan Institute of Genetics, Folkhälsan Research Center; Department of Nephrology, Helsinki University Hospital and University of Helsinki; Research Program for Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland Lena Thorn, Folkhälsan Institute of Genetics, Folkhälsan Research Center; Research Program for Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland Jukka Putaala, Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland Daniel Gordin, Department of Nephrology, Helsinki University Hospital and University of Helsinki; Minerva Institute for Medical Research, Helsinki Finland, Helsinki, Finland Hanna Jokinen, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki; Division of Neuropsychology, HUS Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland Category: Stroke/Cerebrovascular Injury and Disease (Adult) Keyword 1: diabetes Keyword 2: vascular cognitive impairment Keyword 3: computerized neuropsychological testing Objective: Type 1 diabetes (T1D) is related to a significant risk of cerebral small vessel disease (cSVD), manifesting as cerebral microbleeds (CMB) and white matter hyperintensities (WMH) on brain magnetic resonance imaging (MRI). However, the significance of these covert brain changes to cognitive and functional outcomes remains unclear. We investigated the associations of CMB and WMH with objective cognitive performance and subjective work ability in middle-aged adults with T1D without major neurological symptoms. Participants and Methods: Brain MRI and extensive clinical and neuropsychological examinations were performed for 142 individuals with T1D (age 47.2±7.6 years, diabetes duration 31.6±11.0 years, 55.6% women) as part of the ongoing Finnish Diabetic Nephropathy (FinnDiane) study. CMB and WMH were evaluated visually by an experienced neuroradiologist and categorized according to number and severity (CMB: 0 vs 1–2 vs ≥3; WMH: Fazekas score 0 vs ≥1). The cognitive evaluation on processing speed, attention, and executive functions was based on the Wechsler Adult Intelligence Scale-IV (WAIS-IV) Coding and Symbol search subtests, the Stroop test, and the computerized Flexible Attention Test (FAT) subtasks of Simple Visuomotor Speed, Numbers and Number-Letter. Work ability was evaluated with an overall subjective rating (score 0-10) from the Work Ability Index. Results: As evaluated with multiple linear regression analyses adjusted for age and years of education, higher number of CMB (≥3) was associated with poorer performance in WAIS-IV Coding (standardized β=-0.17, p=0.038), FAT Simple Visuomotor Speed (β=0.16, p=0.048), and Stroop color-incongruent part (β=0.18, p=0.038). When CMB and WMH were both entered in the model, higher amount of CMB were independently related to slower performance in Coding (β=-0.17, p=0.045), whereas mild WMH (predominantly Fazekas score 1) were not related to any of the cognitive measures. Likewise, only CMB were negatively associated with overall subjective work ability (β=-0.20, p=0.032) independently of age, education, and WMH. Furthermore, cognitive performance was associated with subjective work ability (Coding β=0.29, p=0.001, Symbol Search β=0.19, p=0.047, Stroop color-congruent β=-0.20, p=0.023; Stroop color-incongruent β=-0.20, p=0.022, FAT Simple Visuomotor Speed β=-0.25, p=0.01, and FAT Number-Letter β=-0.21, p=0.023). Effect sizes of the significant relationships were small (Cohen’s f²=0.04-0.08). Conclusions: Higher number of CMB, but not mild WMH, were related to subtle impairment in processing speed, attention, and executive functions in middle-aged adults with T1D. Both CMB and cognitive deficits were also associated with poorer subjective work ability. The results provide insight into the prevalence of cSVD-related cognitive changes already in midlife and suggest an increased risk of cognitive decline and impaired work ability in individuals with T1D.

Poster

02/16/2024
01:45 pm - 03:00 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 08: Cognition | Cognitive Reserve Variables

Final Abstract #42

Associations of Cerebral Small Vessel Disease with Cognitive Functions and Subjective Work Ability in Middle-Aged Adults with Type 1 Diabetes

Iiris Kyläheiko, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki; Folkhälsan Institute of Genetics, Folkhälsan Research Center; Research Program for Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland
Aleksi Tarkkonen, HUS Medical Imaging Center, Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Juha Martola, HUS Medical Imaging Center, Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Teemu Paajanen, Work Ability and Working Careers Unit, Finnish Institute of Occupational Health, Helsinki, Finland
Jussi Virkkala, Department of Neurophysiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Per-Henrik Groop, Folkhälsan Institute of Genetics, Folkhälsan Research Center; Department of Nephrology, Helsinki University Hospital and University of Helsinki; Research Program for Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland
Lena Thorn, Folkhälsan Institute of Genetics, Folkhälsan Research Center; Research Program for Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland
Jukka Putaala, Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Daniel Gordin, Department of Nephrology, Helsinki University Hospital and University of Helsinki; Minerva Institute for Medical Research, Helsinki Finland, Helsinki, Finland
Hanna Jokinen, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki; Division of Neuropsychology, HUS Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland

Category: Stroke/Cerebrovascular Injury and Disease (Adult)

Keyword 1: diabetes
Keyword 2: vascular cognitive impairment
Keyword 3: computerized neuropsychological testing

Objective:

Type 1 diabetes (T1D) is related to a significant risk of cerebral small vessel disease (cSVD), manifesting as cerebral microbleeds (CMB) and white matter hyperintensities (WMH) on brain magnetic resonance imaging (MRI). However, the significance of these covert brain changes to cognitive and functional outcomes remains unclear. We investigated the associations of CMB and WMH with objective cognitive performance and subjective work ability in middle-aged adults with T1D without major neurological symptoms.

Participants and Methods:

Brain MRI and extensive clinical and neuropsychological examinations were performed for 142 individuals with T1D (age 47.2±7.6 years, diabetes duration 31.6±11.0 years, 55.6% women) as part of the ongoing Finnish Diabetic Nephropathy (FinnDiane) study. CMB and WMH were evaluated visually by an experienced neuroradiologist and categorized according to number and severity (CMB: 0 vs 1–2 vs ≥3; WMH: Fazekas score 0 vs ≥1). The cognitive evaluation on processing speed, attention, and executive functions was based on the Wechsler Adult Intelligence Scale-IV (WAIS-IV) Coding and Symbol search subtests, the Stroop test, and the computerized Flexible Attention Test (FAT) subtasks of Simple Visuomotor Speed, Numbers and Number-Letter. Work ability was evaluated with an overall subjective rating (score 0-10) from the Work Ability Index.

Results:

As evaluated with multiple linear regression analyses adjusted for age and years of education, higher number of CMB (≥3) was associated with poorer performance in WAIS-IV Coding (standardized β=-0.17, p=0.038), FAT Simple Visuomotor Speed (β=0.16, p=0.048), and Stroop color-incongruent part (β=0.18, p=0.038). When CMB and WMH were both entered in the model, higher amount of CMB were independently related to slower performance in Coding (β=-0.17, p=0.045), whereas mild WMH (predominantly Fazekas score 1) were not related to any of the cognitive measures. Likewise, only CMB were negatively associated with overall subjective work ability (β=-0.20, p=0.032) independently of age, education, and WMH. Furthermore, cognitive performance was associated with subjective work ability (Coding β=0.29, p=0.001, Symbol Search β=0.19, p=0.047, Stroop color-congruent β=-0.20, p=0.023; Stroop color-incongruent β=-0.20, p=0.022, FAT Simple Visuomotor Speed β=-0.25, p=0.01, and FAT Number-Letter β=-0.21, p=0.023). Effect sizes of the significant relationships were small (Cohen’s f²=0.04-0.08).

Conclusions:

Higher number of CMB, but not mild WMH, were related to subtle impairment in processing speed, attention, and executive functions in middle-aged adults with T1D. Both CMB and cognitive deficits were also associated with poorer subjective work ability. The results provide insight into the prevalence of cSVD-related cognitive changes already in midlife and suggest an increased risk of cognitive decline and impaired work ability in individuals with T1D.