Associations between anxiety and depression symptoms and cognitive testing and neuroimaging in type 2 diabetes

Aims: Anxiety, depression, accelerated cognitive decline, and increased risk of dementia are observed in individuals with type 2 diabetes. Anxiety and depression may contribute to lower performance on cognitive tests and differences in neuroimaging observed in individuals with type 2 diabetes. Methods: These relationships were assessed in 655 European Americans with type 2 diabetes from 504 Diabetes Heart Study families. Participants completed cognitive testing, brain magnetic resonance imaging, the Brief Symptom Inventory Anxiety subscale, and the Center for Epidemiologic Studies Depression-10. Results: In analyses adjusted for age, sex, educational attainment, and use of psychotropic medications, individuals with comorbid anxiety and depression symptoms had lower performance on all cognitive testing measures assessed (p <= 0.005). Those with both anxiety and depression also had increased white matter lesion volume (p = 0.015), decreased gray matter cerebral blood flow (p = 4.43 x 10(-6)), decreased gray matter volume (p = 0.002), increased white and gray matter mean diffusivity (p <= 0.001), and decreased white matter fractional anisotropy (p = 7.79 x 10(-4)). These associations were somewhat attenuated upon further adjustment for health status related covariates. Conclusions: Comorbid anxiety and depression symptoms were associated with cognitive performance and brain structure in a European American cohort with type 2 diabetes. (C) 2016 Elsevier Inc. All rights reserved.