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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