The paper examines whether diabetes mellitus leads to incident mild cognitive impairment and dementia through brain hypoperfusion and white matter disease. We performed inverse odds ratio weighted causal mediation analyses to decompose the effect of diabetes on cognitive impairment into direct and indirect effects, and we found that approximately a third of the total effect of diabetes is mediated through vascular‐related brain pathology. Our findings lend support for a common aetiological hypothesis regarding incident cognitive impairment, which is that diabetes increases the risk of clinical cognitive impairment in part by impacting the vasculature of the brain.

中文翻译：

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检查脑病理学对糖尿病和认知障碍之间关系的因果中介作用：心血管健康研究

该论文研究了糖尿病是否通过脑灌注不足和白质疾病导致偶发的轻度认知障碍和痴呆。我们进行了逆比值比加权因果中介分析，将糖尿病对认知障碍的影响分解为直接和间接影响，我们发现糖尿病总影响的大约三分之一是通过血管相关的脑病理介导的。我们的研究结果支持关于偶发性认知障碍的常见病因假说，即糖尿病在一定程度上通过影响大脑的脉管系统增加了临床认知障碍的风险。