Clinically Relevant XXXX in Middle-Aged Adults With Childhood-Onset Type 1 Diabetes.

@entity1 @entity66 @entity73 @entity305 @entity1723 @entity989 @entity4854
OBJECTIVE: The aim of this study was to investigate the presence and correlates of clinically relevant @entity73 in middle-aged adults with childhood-onset @entity1723 ( @entity1723 ). RESEARCH DESIGN AND METHODS: During 2010-2013, 97 adults diagnosed with @entity1723 and aged <18 years (age and duration 49    7 and 41    6 years, respectively; 51% female) and 138 similarly aged adults without @entity1723 (age 49    7 years; 55% female) completed extensive neuropsychological testing. Biomedical data on @entity1 with @entity1723 were collected periodically from 1986-1988. @entity73 status was based on the number of test scores >= 1.5 SD worse than demographically appropriate published norms: none, mild (only one test), or clinically relevant (two or more tests). RESULTS: The prevalence of clinically relevant @entity73 was five times higher among @entity1 with than without @entity1723 (28% vs. 5%; P < 0.0001), independent of education, age, or blood pressure. Effect sizes were large (Cohen d 0.6-0.9; P < 0.0001) for psychomotor speed and visuoconstruction tasks, and were modest (d 0.3-0.6; P < 0.05) for measures of executive function. Among @entity1 with @entity1723 , prevalent @entity73 was related to 14-year average A1c >7.5%/58 mmol/mol (odds ratio [OR] 3.0; P = 0.009), @entity989 (OR 2.8; P = 0.01), and distal symmetric @entity305 (OR 2.6; P = 0.03) measured 5 years earlier; higher BMI (OR 1.1; P = 0.03); and ankle-brachial index >= 1.3 (OR 4.2; P = 0.01) measured 20 years earlier, independent of education. CONCLUSION: Clinically relevant @entity73 is highly prevalent among these middle-aged adults with childhood-onset @entity1723 . In this aging cohort, chronic @entity4854 and prevalent @entity66 were associated with @entity73 , relationships shown previously in younger populations with @entity1723 . Two additional potentially modifiable risk factors for @entity1723 -related @entity73 , vascular health and BMI, deserve further study.
