This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.The primary aim of this study is to test whether the rate of cognitive decline and structural brain change in people with diabetes treated with standard care guidelines is different than in people with diabetes treated with intensive care guidelines. This comparison will be made in a sub-sample of 2800 people with diabetes participating in the already funded National Heart Lung and Blood Institute (NHLBI) randomized factorial clinical trial Action to Control Cardiovascular Risk in Diabetes (ACCORD). Structural brain changes will be assessed in 640 participants at 4 centers in the U.S. using a standard MRI imaging protocol at baseline and 40 months of follow-up. ACCORD is designed to evaluate whether more intensive glucose, blood pressure, and lipid management can reduce cardiovascular disease in people with diabetes. The ACCORD trial as a whole, including its sample size, interventions, core measurements, and follow-up procedures, presents a population and study design that could not otherwise be duplicated, due to cost constraints, for a study of the impact of diabetes therapy on cognitive function.
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