IDEAS home Printed from https://ideas.repec.org/a/bla/jorssa/v183y2020i4p1705-1726.html
   My bibliography  Save this article

Examining the causal mediating role of brain pathology on the relationship between diabetes and cognitive impairment: the Cardiovascular Health Study

Author

Listed:
  • Ryan M. Andrews
  • Ilya Shpitser
  • Oscar Lopez
  • William T. Longstreth
  • Paulo H. M. Chaves
  • Lewis Kuller
  • Michelle C. Carlson

Abstract

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.

Suggested Citation

  • Ryan M. Andrews & Ilya Shpitser & Oscar Lopez & William T. Longstreth & Paulo H. M. Chaves & Lewis Kuller & Michelle C. Carlson, 2020. "Examining the causal mediating role of brain pathology on the relationship between diabetes and cognitive impairment: the Cardiovascular Health Study," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 183(4), pages 1705-1726, October.
    • Handle: RePEc:bla:jorssa:v:183:y:2020:i:4:p:1705-1726
    DOI: 10.1111/rssa.12570
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/rssa.12570
    Download Restriction: no
    File URL: https://libkey.io/10.1111/rssa.12570?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Gitanjali M Singh & Goodarz Danaei & Farshad Farzadfar & Gretchen A Stevens & Mark Woodward & David Wormser & Stephen Kaptoge & Gary Whitlock & Qing Qiao & Sarah Lewington & Emanuele Di Angelantonio &, 2013. "The Age-Specific Quantitative Effects of Metabolic Risk Factors on Cardiovascular Diseases and Diabetes: A Pooled Analysis," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-10, July.
    2. Tyler J. Vanderweele, 2011. "Controlled Direct and Mediated Effects: Definition, Identification and Bounds," Scandinavian Journal of Statistics, Danish Society for Theoretical Statistics;Finnish Statistical Society;Norwegian Statistical Association;Swedish Statistical Association, vol. 38(3), pages 551-563, September.
    3. R. M. Daniel & B. L. De Stavola & S. N. Cousens & S. Vansteelandt, 2015. "Causal mediation analysis with multiple mediators," Biometrics, The International Biometric Society, vol. 71(1), pages 1-14, March.
    4. Hudgens, Michael G. & Halloran, M. Elizabeth, 2008. "Toward Causal Inference With Interference," Journal of the American Statistical Association, American Statistical Association, vol. 103, pages 832-842, June.
    5. Caleb H. Miles & Ilya Shpitser & Phyllis Kanki & Seema Meloni & Eric J. Tchetgen Tchetgen, 2017. "Quantifying an Adherence Path-Specific Effect of Antiretroviral Therapy in the Nigeria PEPFAR Program," Journal of the American Statistical Association, Taylor & Francis Journals, vol. 112(520), pages 1443-1452, October.
    6. Steen, Johan & Loeys, Tom & Moerkerke, Beatrijs & Vansteelandt, Stijn, 2017. "medflex: An R Package for Flexible Mediation Analysis using Natural Effect Models," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 76(i11).
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Guanglei Hong & Fan Yang & Xu Qin, 2023. "Posttreatment confounding in causal mediation studies: A cutting‐edge problem and a novel solution via sensitivity analysis," Biometrics, The International Biometric Society, vol. 79(2), pages 1042-1056, June.
    2. Qi Zhang, 2022. "High-Dimensional Mediation Analysis with Applications to Causal Gene Identification," Statistics in Biosciences, Springer;International Chinese Statistical Association, vol. 14(3), pages 432-451, December.
    3. Xiang Zhou, 2022. "Semiparametric estimation for causal mediation analysis with multiple causally ordered mediators," Journal of the Royal Statistical Society Series B, Royal Statistical Society, vol. 84(3), pages 794-821, July.
    4. Evan Munro & David Jones & Jennifer Brennan & Roland Nelet & Vahab Mirrokni & Jean Pouget-Abadie, 2023. "Causal Estimation of User Learning in Personalized Systems," Papers 2306.00485, arXiv.org.
    5. Tiziano Arduini & Eleonora Patacchini & Edoardo Rainone, 2020. "Treatment Effects With Heterogeneous Externalities," Journal of Business & Economic Statistics, Taylor & Francis Journals, vol. 38(4), pages 826-838, October.
    6. Anup Malani & Cynthia Kinnan & Gabriella Conti & Kosuke Imai & Morgen Miller & Shailender Swaminathan & Alessandra Voena & Bartosz Woda, 2024. "Evaluating pricing health insurance in lower-income countries: A field experiment in India," IFS Working Papers W24/33, Institute for Fiscal Studies.
    7. Malani, Anup & Holtzman, Phoebe & Imai, Kosuke & Kinnan, Cynthia & Miller, Morgen & Swaminathan, Shailender & Voena, Alessandra & Woda, Bartek & Conti, Gabriella, 2021. "Effect of Health Insurance in India: A Randomized Controlled Trial," IZA Discussion Papers 14913, Institute of Labor Economics (IZA).
    8. Yi Zhang & Kosuke Imai, 2023. "Individualized Policy Evaluation and Learning under Clustered Network Interference," Papers 2311.02467, arXiv.org, revised Mar 2025.
    9. Tadao Hoshino & Takahide Yanagi, 2024. "Causal Inference with Noncompliance and Unknown Interference," Journal of the American Statistical Association, Taylor & Francis Journals, vol. 119(548), pages 2869-2880, October.
    10. Cai Xiaoxuan & Loh Wen Wei & Crawford Forrest W., 2021. "Identification of causal intervention effects under contagion," Journal of Causal Inference, De Gruyter, vol. 9(1), pages 9-38, January.
    11. Acharya, Avidit & Blackwell, Matthew & Sen, Maya, 2016. "Explaining Causal Findings Without Bias: Detecting and Assessing Direct Effects," American Political Science Review, Cambridge University Press, vol. 110(3), pages 512-529, August.
    12. Senne Vandevelde & Bjorn Van Campenhout & Wilberforce Walukano, 2018. "Spoiler alert! Spillovers in the context of a video intervention to maintain seed quality among Ugandan potato farmers," Working Papers of LICOS - Centre for Institutions and Economic Performance 634335, KU Leuven, Faculty of Economics and Business (FEB), LICOS - Centre for Institutions and Economic Performance.
    13. Luofeng Liao & Yuan Gao & Christian Kroer, 2022. "Statistical Inference for Fisher Market Equilibrium," Papers 2209.15422, arXiv.org, revised Feb 2025.
    14. Michael P. Leung, 2024. "Identifying Treatment and Spillover Effects Using Exposure Contrasts," Papers 2403.08183, arXiv.org, revised Dec 2024.
    15. John Kidd & Dan-Yu Lin, 2024. "Improving the Power to Detect Indirect Effects in Mediation Analysis," Statistics in Biosciences, Springer;International Chinese Statistical Association, vol. 16(1), pages 129-141, April.
    16. Yann Bramoullé & Habiba Djebbari & Bernard Fortin, 2020. "Peer Effects in Networks: A Survey," Annual Review of Economics, Annual Reviews, vol. 12(1), pages 603-629, August.
    17. Giovanni Cerulli, 2014. "ntreatreg: a Stata module for estimation of treatment effects in the presence of neighborhood interactions," United Kingdom Stata Users' Group Meetings 2014 15, Stata Users Group.
    18. Violeta Chacon & Guillermo Paraje & Joaquin Barnoya & Frank J Chaloupka, 2018. "Own-price, cross-price, and expenditure elasticities on sugar-sweetened beverages in Guatemala," PLOS ONE, Public Library of Science, vol. 13(10), pages 1-12, October.
    19. Luofeng Liao & Christian Kroer, 2024. "Statistical Inference and A/B Testing in Fisher Markets and Paced Auctions," Papers 2406.15522, arXiv.org, revised Mar 2025.
    20. Carolina Perez-Heydrich & Michael G. Hudgens & M. Elizabeth Halloran & John D. Clemens & Mohammad Ali & Michael E. Emch, 2014. "Assessing effects of cholera vaccination in the presence of interference," Biometrics, The International Biometric Society, vol. 70(3), pages 731-741, September.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bla:jorssa:v:183:y:2020:i:4:p:1705-1726. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: https://edirc.repec.org/data/rssssea.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.