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

Laura M. Raffield, Gretchen A. Brenes, Amanda J. Cox, Barry I. Freedman, Christina E. Hugenschmidt, Fang Chi Hsu, Jianzhao Xu, Benjamin C. Wagner, Jeff D. Williamson, Joseph A Maldjian, Donald W. Bowden

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


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 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 × 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.

Original languageEnglish (US)
Pages (from-to)143-149
Number of pages7
JournalJournal of Diabetes and Its Complications
Issue number1
StatePublished - Jan 1 2016


  • Anxiety
  • Cognition
  • Depression
  • Magnetic resonance imaging
  • Type 2 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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