Diabetes in Midlife Shrinks the Brain

From MedPageToday.com

Diabetes in Midlife Shrinks the Brain
Published: Mar 19, 2014
By Salynn Boyles, Contributing Writer, MedPage Today
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco

Onset of type 2 diabetes in middle age appears to affect late-life cognition by reducing brain volume, MRI studies revealed in a population-based cohort without dementia.

Compared with never developing diabetes, developing diabetes in midlife was associated with an 85% increase in subcortical infarctions on MRI analysis (OR, 1.85 [95% CI 1.09-3.15; P=0.02), a 4% reduction in hippocampal volume (95% CI -7.0-minus 1.0; P=0.01), and a 2.9% reduction in whole brain volume, according to researcher Rosebud O. Roberts, MB, Ch.B, of the Mayo Clinic, Rochester, and colleagues.

Diabetes onset after age 64 did not appear to impact brain pathology or cognitive performance, suggesting that the deleterious impact of the disease on memory and other aspects of brain function occurs over decades, they wrote in the April 1 issue of the journal Neurology.

Midlife hypertension was associated with subcortical infarctions and whole brain volume declines, and was marginally associated with reduced performance in executive function during cognitive testing.

"Our study shows that the earlier you have these conditions, the worse your brain pathology is late in life," Roberts told MedPage Today.

Diabetes and hypertension have been associated with ischemic lesions in the brain and other organs in previous studies, as well as Alzheimer's pathology and brain atrophy, but the mechanisms by which these conditions influence cognitive impairment are not well understood, the researchers wrote.

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