{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:21:26Z","timestamp":1787163686793,"version":"build-2736575974"},"reference-count":40,"publisher":"American Diabetes Association","issue":"11","license":[{"start":{"date-parts":[[2021,9,29]],"date-time":"2021-09-29T00:00:00Z","timestamp":1632873600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Type 2 diabetes is associated with increased risks of cognitive dysfunction and brain abnormalities. The extent to which risk factor modification can mitigate these risks is unclear. We investigated the associations between incident dementia, cognitive performance, and brain abnormalities among individuals with type 2 diabetes, according to the number of risk factors on target, compared with control subjects without diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>Prospective data were from UK Biobank of 87,856 individuals (n = 10,663 diabetes, n = 77,193 control subjects; baseline 2006\u20132010), with dementia follow-up until February 2018. Individuals with diabetes were categorized according to the number of seven selected risk factors within the guideline-recommended target range (nonsmoking; guideline-recommended levels of glycated hemoglobin, blood pressure, BMI, albuminuria, physical activity, and diet). Outcomes were incident dementia, domain-specific cognitive performance, white matter hyperintensities, and total brain volume.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>After a mean follow-up of 9.0 years, 147 individuals (1.4%) with diabetes and 412 control subjects (0.5%) had incident dementia. Among individuals with diabetes, excess dementia risk decreased stepwise for a higher number of risk factors on target. Compared with control subjects (incidence rate per 1,000 person-years 0.62 [95% CI 0.56; 0.68]), individuals with diabetes who had five to seven risk factors on target had no significant excess dementia risk (absolute rate difference per 1,000 person-years 0.20 [\u22120.11; 0.52]; hazard ratio 1.32 [0.89; 1.95]). Similarly, differences in processing speed, executive function, and brain volumes were progressively smaller for a higher number of risk factors on target. These results were replicated in the Maastricht Study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Among individuals with diabetes, excess dementia risk, lower cognitive performance, and brain abnormalities decreased stepwise for a higher number of risk factors on target.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc21-0149","type":"journal-article","created":{"date-parts":[[2021,9,29]],"date-time":"2021-09-29T08:45:40Z","timestamp":1632905140000},"page":"2493-2502","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":46,"title":["Association of Type 2 Diabetes, According to the Number of Risk Factors Within Target Range, With Structural Brain Abnormalities, Cognitive Performance, and Risk of Dementia"],"prefix":"10.2337","volume":"44","author":[{"given":"April C.E.","family":"van Gennip","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands"},{"name":"School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coen D.A.","family":"Stehouwer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands"},{"name":"School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin P.J.","family":"van Boxtel","sequence":"additional","affiliation":[{"name":"School for Mental Health and Neuroscience MHENS, Maastricht University, Maastricht, the Netherlands"},{"name":"Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frans R.J.","family":"Verhey","sequence":"additional","affiliation":[{"name":"School for Mental Health and Neuroscience MHENS, Maastricht University, Maastricht, the Netherlands"},{"name":"Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemarie","family":"Koster","sequence":"additional","affiliation":[{"name":"Care and Public Health Research Institute CAPHRI, Maastricht University, Maastricht, the Netherlands"},{"name":"Department of Social Medicine, Maastricht University, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abraham A.","family":"Kroon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands"},{"name":"School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"K\u00f6hler","sequence":"additional","affiliation":[{"name":"School for Mental Health and Neuroscience MHENS, Maastricht University, Maastricht, the Netherlands"},{"name":"Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marleen M.J.","family":"van Greevenbroek","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands"},{"name":"School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anke","family":"Wesselius","sequence":"additional","affiliation":[{"name":"School of Nutrition and Translational Research in Metabolism NUTRIM, Maastricht University, Maastricht, the Netherlands"},{"name":"Department of Genetics and Cell Biology, Complex Genetics, Maastricht University Medical Centre, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone J.P.M.","family":"Eussen","sequence":"additional","affiliation":[{"name":"School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, the Netherlands"},{"name":"Department of Epidemiology, Maastricht University Medical Centre, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter H.","family":"Backes","sequence":"additional","affiliation":[{"name":"School for Mental Health and Neuroscience MHENS, Maastricht University, Maastricht, the Netherlands"},{"name":"Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacobus F.","family":"Jansen","sequence":"additional","affiliation":[{"name":"School for Mental Health and Neuroscience MHENS, Maastricht University, Maastricht, the Netherlands"},{"name":"Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands"},{"name":"Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miranda T.","family":"Schram","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands"},{"name":"School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, the Netherlands"},{"name":"School for Mental Health and Neuroscience MHENS, Maastricht University, Maastricht, the Netherlands"},{"name":"Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the 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