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dc.contributor.authorEspeland, Mark A.
dc.contributor.authorBrinton, Roberta Diaz.
dc.contributor.authorHugenschmidt, Christina
dc.contributor.authorManson, JoAnn E.
dc.contributor.authorCraft, Suzanne
dc.contributor.authorYaffe, Kristine
dc.contributor.authorWeitlauf, Julie
dc.contributor.authorVaughan, Leslie
dc.contributor.authorJohnson, Karen C.
dc.contributor.authorPadula, Claudia B.
dc.contributor.authorJackson, Rebecca D.
dc.contributor.authorResnick, Susan M.
dc.contributor.authorWHIMS Study Group
dc.contributor.authorOckene, Judith K.
dc.date2022-08-11T08:10:19.000
dc.date.accessioned2022-08-23T17:04:20Z
dc.date.available2022-08-23T17:04:20Z
dc.date.issued2015-12-01
dc.date.submitted2017-07-13
dc.identifier.citationDiabetes Care. 2015 Dec;38(12):2316-24. doi: 10.2337/dc15-1385. Epub 2015 Oct 20. <a href="https://doi.org/10.2337/dc15-1385">Link to article on publisher's site</a>
dc.identifier.issn0149-5992 (Linking)
dc.identifier.doi10.2337/dc15-1385
dc.identifier.pmid26486190
dc.identifier.urihttp://hdl.handle.net/20.500.14038/44619
dc.description<p>Judith Ockene is a collaborator in the for the WHIMS Study Group. For full list of collaborators see article.</p>
dc.description.abstractOBJECTIVE: In older women, higher levels of estrogen may exacerbate the increased risk for cognitive impairment conveyed by diabetes. We examined whether the effect of postmenopausal hormone therapy (HT) on cognitive impairment incidence differs depending on type 2 diabetes. RESEARCH DESIGN AND METHODS: The Women's Health Initiative (WHI) randomized clinical trials assigned women to HT (0.625 mg/day conjugated equine estrogens with or without [i.e., unopposed] 2.5 mg/day medroxyprogesterone acetate) or matching placebo for an average of 4.7-5.9 years. A total of 7,233 women, aged 65-80 years, were classified according to type 2 diabetes status and followed for probable dementia and cognitive impairment (mild cognitive impairment or dementia). RESULTS: Through a maximum of 18 years of follow-up, women with diabetes had increased risk of probable dementia (hazard ratio [HR] 1.54 [95% CI 1.16-2.06]) and cognitive impairment (HR 1.83 [1.50-2.23]). The combination of diabetes and random assignment to HT increased their risk of dementia (HR 2.12 [1.47-3.06]) and cognitive impairment (HR 2.20 [1.70-2.87]) compared with women without these conditions, interaction P = 0.09 and P = 0.08. These interactions appeared to be limited to women assigned to unopposed conjugated equine estrogens. CONCLUSIONS: These analyses provide additional support to a prior report that higher levels of estrogen may exacerbate risks that type 2 diabetes poses for cognitive function in older women. The role estrogen plays in suppressing non-glucose-based energy sources in the brain may explain this interaction. long as the work is properly cited, the use is educational and not for profit, and the work is not altered.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=26486190&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657616/
dc.subjectEndocrinology, Diabetes, and Metabolism
dc.subjectObstetrics and Gynecology
dc.subjectPsychiatry and Psychology
dc.subjectWomen's Health
dc.titleImpact of Type 2 Diabetes and Postmenopausal Hormone Therapy on Incidence of Cognitive Impairment in Older Women
dc.typeJournal Article
dc.source.journaltitleDiabetes care
dc.source.volume38
dc.source.issue12
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/prc_pubs/58
dc.identifier.contextkey10425618
html.description.abstract<p>OBJECTIVE: In older women, higher levels of estrogen may exacerbate the increased risk for cognitive impairment conveyed by diabetes. We examined whether the effect of postmenopausal hormone therapy (HT) on cognitive impairment incidence differs depending on type 2 diabetes.</p> <p>RESEARCH DESIGN AND METHODS: The Women's Health Initiative (WHI) randomized clinical trials assigned women to HT (0.625 mg/day conjugated equine estrogens with or without [i.e., unopposed] 2.5 mg/day medroxyprogesterone acetate) or matching placebo for an average of 4.7-5.9 years. A total of 7,233 women, aged 65-80 years, were classified according to type 2 diabetes status and followed for probable dementia and cognitive impairment (mild cognitive impairment or dementia).</p> <p>RESULTS: Through a maximum of 18 years of follow-up, women with diabetes had increased risk of probable dementia (hazard ratio [HR] 1.54 [95% CI 1.16-2.06]) and cognitive impairment (HR 1.83 [1.50-2.23]). The combination of diabetes and random assignment to HT increased their risk of dementia (HR 2.12 [1.47-3.06]) and cognitive impairment (HR 2.20 [1.70-2.87]) compared with women without these conditions, interaction P = 0.09 and P = 0.08. These interactions appeared to be limited to women assigned to unopposed conjugated equine estrogens.</p> <p>CONCLUSIONS: These analyses provide additional support to a prior report that higher levels of estrogen may exacerbate risks that type 2 diabetes poses for cognitive function in older women. The role estrogen plays in suppressing non-glucose-based energy sources in the brain may explain this interaction. long as the work is properly cited, the use is educational and not for profit, and the work is not altered.</p>
dc.identifier.submissionpathprc_pubs/58
dc.contributor.departmentDepartment of Medicine, Division of Preventive and Behavioral Medicine
dc.contributor.departmentPrevention Research Center
dc.source.pages2316-24


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