Examining the causal mediating role of brain pathology on the relationship between diabetes and cognitive impairment: the Cardiovascular Health Study

Ryan M. Andrews, Ilya Shpitser, Oscar Lopez, William T. Longstreth, Paulo H.M. Chaves, Lewis Kuller, Michelle C. Carlson

Research output: Contribution to journalArticlepeer-review

Abstract

The paper examines whether diabetes mellitus leads to incident mild cognitive impairment and dementia through brain hypoperfusion and white matter disease. We performed inverse odds ratio weighted causal mediation analyses to decompose the effect of diabetes on cognitive impairment into direct and indirect effects, and we found that approximately a third of the total effect of diabetes is mediated through vascular-related brain pathology. Our findings lend support for a common aetiological hypothesis regarding incident cognitive impairment, which is that diabetes increases the risk of clinical cognitive impairment in part by impacting the vasculature of the brain.

Original languageEnglish (US)
Pages (from-to)1705-1726
Number of pages22
JournalJournal of the Royal Statistical Society. Series A: Statistics in Society
Volume183
Issue number4
DOIs
StatePublished - Oct 1 2020

Keywords

  • Alzheimer's disease
  • Causal inference
  • Causal mediation analysis
  • Cognitive neuroscience
  • Public health

ASJC Scopus subject areas

  • Statistics and Probability
  • Social Sciences (miscellaneous)
  • Economics and Econometrics
  • Statistics, Probability and Uncertainty

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