Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, VIC, Australia.
Baker Heart & Diabetes Institute, Melbourne, VIC, Australia.
Neuropsychopharmacology. 2023 Jan;48(2):362-370. doi: 10.1038/s41386-022-01471-6. Epub 2022 Oct 15.
Type 2 diabetes (T2D) is disproportionately prevalent in bipolar disorder (BD) and is associated with cognitive deficits in psychiatrically healthy cohorts. Whether there is an interaction effect between T2D and BD on cognition remains unclear. Using the UK Biobank, we explored interactions between T2D, BD and cognition during mid and later life; and examined age-related cognitive performance effects in BD as a function of T2D. Data were available for 1511 participants with BD (85 T2D), and 81,162 psychiatrically healthy comparisons (HC) (3430 T2D). BD and T2D status were determined by validated measures created specifically for the UK Biobank. Diagnostic and age-related associations between T2D status and cognition were tested using analyses of covariance or logistic regression. There was a negative association of T2D with visuospatial memory that was specific to BD. Processing speed and prospective memory performance were negatively associated with T2D, irrespective of BD diagnosis. Cognitive deficits were evident in BD patients with T2D compared to those without, with scores either remaining the same (processing speed) or improving (visuospatial memory) as a function of participant age. In contrast, cognitive performance in BD patients without T2D was worse as participant age increased, although the age-related trajectory remained broadly equivalent to the HC group. BD and T2D associated with cognitive performance deficits across the mid-life period; indicating comorbid T2D as a potential risk factor for cognitive dysfunction in BD. In comparison to BD participants without T2D and HCs, age-independent cognitive impairments in BD participants with comorbid T2D suggest a potential premature deterioration of cognitive functioning compared to what would normally be expected.
2 型糖尿病（T2D）在双相情感障碍（BD）中发病率不成比例，与精神健康队列的认知缺陷有关。T2D 和 BD 是否对认知有相互作用影响尚不清楚。本研究使用英国生物库，探讨了中年和晚年期间 T2D、BD 和认知之间的相互作用；并检查了作为 T2D 函数的 BD 中与年龄相关的认知表现效应。共有 1511 名 BD 患者（85 名 T2D）和 81162 名精神健康对照者（HC）（3430 名 T2D）的数据可用。BD 和 T2D 状态通过专门为英国生物库创建的验证措施确定。使用协方差分析或逻辑回归检验 T2D 状态与认知之间的诊断和年龄相关关联。T2D 与 BD 特异性的视空间记忆呈负相关。无论 BD 诊断如何，处理速度和前瞻性记忆表现均与 T2D 呈负相关。与没有 T2D 的 BD 患者相比，有 T2D 的 BD 患者的认知缺陷更为明显，其分数要么保持不变（处理速度），要么随参与者年龄的增加而提高（视空间记忆）。相比之下，BD 患者没有 T2D 的认知表现随着年龄的增长而恶化，尽管年龄相关轨迹大致与 HC 组相当。BD 和 T2D 与中年时期的认知表现缺陷有关；表明合并 T2D 是 BD 认知功能障碍的潜在危险因素。与没有 T2D 的 BD 参与者和 HC 相比，合并 T2D 的 BD 参与者的年龄独立认知损伤表明与正常预期相比，认知功能可能会提前恶化。
