ACCORD-MIND is funded through an intra-agency agreement between NHLBI and NIA. It is a sub-study nested within the randomized factorial clinical trial - Action to Control Cardiovascular Risk in Diabetics (ACCORD). ACCORD evaluates whether more intensive glucose, blood pressure and lipid management can reduce cardiovascular disease in people with diabetes. ACCORD-MIND is designed to test in a sub-sample of ACCORD participants, whether the intensive interventions can also reduce the rates of cognitive decline and structural brain change. The overall interventions in the ACCORD trial include interventons for glycemic control, HDL-C levels, and blood pressure. Participants in ACCORD-MIND were already randomly assigned to the ACCORD treatment groups. Brain outcomes are assessed with tests of cognitive function (memory and perceptual speed) and MRI scans of brain structure. The cognitive testing is performed in clinics located within six ACCORD networks (Southeast, Northeast, Minnesota-Iowa, Western, Ohio, and Canadian), and the MRI in 4 of the networks. Cognitive testing is performed at the baseline visit, and then 20 and 40 months thereafter;MRIs are acquired at baseline and 40 mos follow-up. Baseline recruitment for the ACCORD-MIND study is now complete;a total of 2977 persons were tested and 630 MRIs acquired. The 20 month follow up is also completed with >95% retention.m In Feb, 2008 the intensive glcemic intervention was stopped and all patients transitioned to standard care. The blood pressure and lipidemia arms continue. The trial ended June 2009 and results will be submitted for publication September, 2011. One more measure of cognitive function and acquisition of MRI, funded through an intra-agency agreement with NHLBI, was started in May, 2011 as a part of ACCORDION. Data collection is on-going. In addition several epidemiologic studies have been completed or are in process. This includes studies of diabetes and cognition, MRI findings, cerebral microbleeds, hypoglycemia, kidney and retinal disease associations.

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National Institute on Aging (NIA)
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Freedman, Barry I; Sink, Kaycee M; Hugenschmidt, Christina E et al. (2017) Associations of Early Kidney Disease With Brain Magnetic Resonance Imaging and Cognitive Function in African Americans With Type 2 Diabetes Mellitus. Am J Kidney Dis 70:627-637
Murray, Anne M; Hsu, Fang-Chi; Williamson, Jeff D et al. (2017) ACCORDION MIND: results of the observational extension of the ACCORD MIND randomised trial. Diabetologia 60:69-80
Cukierman-Yaffe, Tali; Gerstein, Hertzel C; Miller, Michael E et al. (2017) The relationship between the score on a simple measure of cognitive function & incident CVD in people with diabetes: a post-hoc epidemiological analysis from the ACCORD-MIND study. J Clin Endocrinol Metab :
van Sloten, Thomas T; Sigurdsson, Sigurdur; van Buchem, Mark A et al. (2015) Cerebral Small Vessel Disease and Association With Higher Incidence of Depressive Symptoms in a General Elderly Population: The AGES-Reykjavik Study. Am J Psychiatry 172:570-8
Ding, Jie; Sigurdsson, Sigurdur; Garcia, Melissa et al. (2015) Risk Factors Associated With Incident Cerebral Microbleeds According to Location in Older People: The Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study. JAMA Neurol 72:682-8
Qiu, Chengxuan; Sigurdsson, Sigurdur; Zhang, Qian et al. (2014) Diabetes, markers of brain pathology and cognitive function: the Age, Gene/Environment Susceptibility-Reykjavik Study. Ann Neurol 75:138-46
Williamson, Jeff D; Launer, Lenore J; Bryan, R Nick et al. (2014) Cognitive function and brain structure in persons with type 2 diabetes mellitus after intensive lowering of blood pressure and lipid levels: a randomized clinical trial. JAMA Intern Med 174:324-33
Bryan, R Nick; Bilello, Michel; Davatzikos, Christos et al. (2014) Effect of diabetes on brain structure: the action to control cardiovascular risk in diabetes MR imaging baseline data. Radiology 272:210-6
Hugenschmidt, Christina E; Lovato, James F; Ambrosius, Walter T et al. (2014) The cross-sectional and longitudinal associations of diabetic retinopathy with cognitive function and brain MRI findings: the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Diabetes Care 37:3244-52
Sullivan, Mark D; Katon, Wayne J; Lovato, Laura C et al. (2013) Association of depression with accelerated cognitive decline among patients with type 2 diabetes in the ACCORD-MIND trial. JAMA Psychiatry 70:1041-7

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