ReviewJournal of the American Geriatrics Society2022
Mediation effects of diabetes and inflammation on the relationship of obesity to cognitive impairment in African Americans.
Review in Journal of the American Geriatrics Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 12 citations in OpenAlex.
- Trial
- Interleukin-5: an indicator of mild cognitive impairment in patients with type 2 diabetes mellitus - a comprehensive investigation ranging from bioinformatics analysis to clinical research.Journal of endocrinological investigation · 2025Article
- Mechanistic exploration of obesity-related indicators and motor cognitive risk syndrome: a mediated effect based on C-reactive protein triglyceride glucose index.Frontiers in aging neuroscience · 2025Article
- Article
- Risk factors for cognitive impairment in middle-aged type 2 diabetic patients: a cross-sectional study.BMJ open · 2024Article
- Exploring galectin-3's role in predicting mild cognitive impairment in type 2 diabetes and its regulation by miRNAs.Frontiers in medicine · 2024Article
- Validation of prevalent diabetes risk scores based on non-invasively measured predictors in Ghanaian migrant and non-migrant populations - The RODAM study.Public health in practice (Oxford, England) · 2023Article
- A risk prediction model based on machine learning for early cognitive impairment in hypertension: Development and validation study.Frontiers in public health · 2023Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundWhether diabetes and adipokine-driven inflammation explain the association of obesity to cognitive impairment is unknown.
methodsStructural equation models estimated the total effects of waist circumference on cognitive outcomes among African American participants cross-sectionally (index exam) and longitudinally. Total effects were deconstructed into direct pathways of waist circumference to cognitive impairment and indirect mediation pathways through leptin, soluble tumor necrosis factor receptor 2 (sTNFR2), and diabetes. Waist circumference, leptin, and sTNFR2 were standardized. Cognitive impairment was defined as MMSE <21 or a z-score < -1.5 standard deviation (SD). Incident cognitive impairment was defined among those without cognitive impairment at the index exam as follow-up MMSE<21, z- score < -1.5, MMSE decline >1 point/year, or z-score decline of >0.1 SD/year.
resultsAmong 1008 participants (70% women, mean age 62.9 years, 14.5% with obesity, 26% with diabetes), 132 (13%) had baseline cognitive impairment. Each SD higher waist circumference was associated with higher odds of cognitive impairment, odds ratio (OR) = 1.63; (95% confidence interval: 1.17, 2.24), with mediating pathways explaining 65% of the total effect (58% from diabetes; 7% from inflammation). At follow-up (mean 6.8 years), 106 of 535 (19.8%) had developed cognitive impairment. Each SD higher waist circumference was associated with higher odds of developing cognitive impairment (OR = 1.87; 95%CI: 1.18, 2.74); the direct effect of waist circumference explained 37% of the total effect and mediating pathways explained 63% (61% from diabetes; 2% from inflammation), although individual pathways were not statistically supported in the smaller sample.
conclusionDiabetes, and to a lesser degree, adiposity-driven inflammation, appear to explain a substantial proportion of abdominal adiposity relationships with cognitive impairment. The impact of preventing and treating obesity on cognitive outcomes merits study.
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